| Doctor Name: | AMBER KICKLIGHTER EDENFIELD |
| NPI Number: | 1114275724 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAPC |
| License Number: | APC003352 |
| Business Practice Address: | 207 N Anderson Dr Swainsboro, GA - 304014440 |
| Business Phone Number: | 4782892619 |
| Business Fax Number: | 4782892622 |
| Mailing Address: | 223 N Anderson Dr, P O Box 1259 SWAINSBORO |
| State: | GA |
| Postal Code: | 304014440 |
| Phone Number: | 4782892683 |
| Fax Number: | 4782892522 |
| NPI Enumeration Date: | 08/29/2012 |
| NPI Last Update Date: | 08/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | APC003352 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |