Individual
MS. AMANDA SUE BENAVIDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1621 EAST CORRAL, KINGSVILLE, TX 78363
(361) 592-6481
(361) 362-0695
Mailing address
P.O. BOX 1336, PORTLAND, TX 78374-2213
(361) 777-3991
(361) 777-0610
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
74828
TX
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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