Individual
AMANDA MANRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1585 N 113TH AVE STE 103, AVONDALE, AZ 85392-3938
(623) 322-8250
Mailing address
15116 N COTTON LN, SURPRISE, AZ 85388-9618
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
17-45269
CA
235Z00000X
Speech-Language Pathologist
Primary
TSLP15360
AZ
Other
Enumeration date
03/09/2018
Last updated
09/10/2024
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