Individual
AMANDA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1990 E LOHMAN AVE, LAS CRUCES, NM 88001-3172
(575) 524-4813
(575) 524-4813
Mailing address
505 S MAIN ST, STE249, LAS CRUCES, NM 88001-1206
(575) 527-5884
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2023-1363
NM
235Z00000X
Speech-Language Pathologist
C-5358
NM
Other
Enumeration date
08/09/2013
Last updated
01/03/2024
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