Individual
MISS AMANIE MAHMOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4927 LAKE RIDGE PKWY STE 120, GRAND PRAIRIE, TX 75052-3066
(855) 782-7822
Mailing address
2943 SENDERO, GRAND PRAIRIE, TX 75054-0167
(817) 726-1939
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TX
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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