Individual
AMANDA PICKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
4111 MARATHON BLVD STE 110, AUSTIN, TX 78756-3753
(512) 222-3198
Mailing address
4111 MARATHON BLVD STE 110, AUSTIN, TX 78756-3753
(512) 222-3198
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01935
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC01935
TEXAS MEDICAL BOARD
TX
Enumeration date
10/11/2019
Last updated
10/11/2019
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