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General NPI Number Information
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NPI Number | 1891658621
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Entity Type | Individual
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Provider Name | AMANDA INGE
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Gender | Female
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1012 MARQUEZ PL UNIT 106B
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City | SANTA FE
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State | NM
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Zip | 87505-1833
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Country | US
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Telephone | 866-273-2451
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Fax | 866-608-5560
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Provider Business Mailing Address
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Address Line | 1408 8TH ST
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City | ALAMOGORDO
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State | NM
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Zip | 88310-5115
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Country | US
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Telephone | 866-273-2451
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Fax | 866-608-5560
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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