Provider Demographics
NPI:1457937476
Name:SISK, SAVANNAH ELIZABETH/MARGARET
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:ELIZABETH/MARGARET
Last Name:SISK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4617 NOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38002-5135
Mailing Address - Country:US
Mailing Address - Phone:901-421-9035
Mailing Address - Fax:
Practice Address - Street 1:4617 NOB HILL DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38002-5135
Practice Address - Country:US
Practice Address - Phone:901-421-9035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-21
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker