Individual
AMANDA LEE HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5804 BOAT CLUB RD, FORT WORTH, TX 76179
(817) 310-8792
Mailing address
5804 BOAT CLUB RD, FORT WORTH, TX 76179
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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