Individual
MRS. AMANDA MOORE TRAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
14086 AIRLINE HWY APT 2423, GONZALES, LA 70737-0623
(803) 610-5133
Mailing address
14086 AIRLINE HWY APT 2423, GONZALES, LA 70737-0623
(803) 610-5133
Taxonomy
Speciality
Code
Description
License number
State
156FX1101X
Ophthalmic Assistant
—
—
183700000X
Pharmacy Technician
Primary
30011620
LA
3336C0003X
Community/Retail Pharmacy
30011620
LA
3336L0003X
Long Term Care Pharmacy
30011620
LA
Other
Enumeration date
03/18/2022
Last updated
03/23/2022
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