Individual
MRS. AMANDA MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4423 SHADOWDALE, HOUSTON, TX 77041
(281) 392-4221
Mailing address
5419 RIO SAN JUAN, ROSHARRON, TX 77583
(832) 803-2810
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
760199836
TX
235Z00000X
Speech-Language Pathologist
Primary
105406
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105406
PROFESSIONIAL LICENSE
TX
Enumeration date
07/05/2016
Last updated
07/05/2016
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