Healthcare Provider Details

I. General information

NPI: 1417727488
Provider Name (Legal Business Name): AMANDA STILES-HARBER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 EMERY ST STE 530
DENTON TX
76201-2478
US

IV. Provider business mailing address

421 DEMPSTER CT
OAK POINT TX
75068-6138
US

V. Phone/Fax

Practice location:
  • Phone: 940-808-1018
  • Fax:
Mailing address:
  • Phone: 214-681-2127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: