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Individual

AMBER S LOCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SW

Contact information

Practice address
1759 BROAD PARK CIR S STE 113, MANSFIELD, TX 76063-7836
(817) 473-1312
Mailing address
1759 BROAD PARK CIR S STE 113, MANSFIELD, TX 76063-7836

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
W9442
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
404951201
TX
Enumeration date
09/02/2020
Last updated
09/02/2020
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