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NPI Code Detail

MEDICARE: AUDREY KENDALL MANN

MEDICARE: AUDREY KENDALL MANN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1942163456
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY KENDALL MANN
Provider Business Mailing Address
First Line : 9165 WICHITA TRL
Second Line :
City : FRISCO
State : TX
Zip : 75033-7609
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2655 VILLA CREEK DR STE 140
Second Line :
City : FARMERS BRANCH
State : TX
Zip : 75234-7385
Country : US
Telephone Number : 214-736-8376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ AUDREY KENDALL MANN ” Practice Location

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