Individual
AMANDA RENEE FORBES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 COURT ST, PORT ALLEN, LA 70767-2747
(225) 245-9070
(225) 245-9073
Mailing address
415 COURT ST, PORT ALLEN, LA 70767-2747
(225) 245-9070
(225) 345-9073
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124567411
—
LA
Enumeration date
11/17/2020
Last updated
11/17/2020
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