Individual
AMANDA LARUE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
132 S FM 706, LUFKIN, TX 75904-0201
(936) 635-0309
(936) 632-6127
Mailing address
132 S FM 706, LUFKIN, TX 75904-0201
(936) 635-0309
(936) 632-6127
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
793269
TX
Other
Enumeration date
11/22/2013
Last updated
06/19/2020
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