Healthcare Provider Details

I. General information

NPI: 1154094217
Provider Name (Legal Business Name): AMBER DANFORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 E AMADOR AVE
LAS CRUCES NM
88001-3677
US

IV. Provider business mailing address

277 E AMADOR AVE
LAS CRUCES NM
88001-3677
US

V. Phone/Fax

Practice location:
  • Phone: 505-392-3482
  • Fax:
Mailing address:
  • Phone: 505-392-3482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: