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Individual

RECA LAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
4104 SW 33RD AVE, AMARILLO, TX 79109-1203
(806) 803-9671
Mailing address
7212 HATTON RD, AMARILLO, TX 79110-4329
(806) 640-7646

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
67648
TX

Other

Enumeration date
06/24/2019
Last updated
06/24/2019
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