MEDICARE: AMANDA PRICE

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
1	103K00000X	Behavior Analyst	1-16-22700	TX

General Provider Information

NPI Number	:	1114437126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA PRICE

Provider Business Mailing Address
First Line	:	2407 HAINE DR
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8592
Country	:	US
Telephone Number	:	866-437-2165
Fax Number	:

Provider Business Practice Location Address
First Line	:	2407 HAINE DR
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8592
Country	:	US
Telephone Number	:	866-437-2165
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	10/04/2017

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Directions to “ AMANDA PRICE ” Practice Location

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