Individual
AMANDA PEDRIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
903 PARKVIEW CIR, HEWITT, TX 76643-3265
(903) 312-1315
(866) 790-8027
Mailing address
903 PARKVIEW CIR, HEWITT, TX 76643-3265
(903) 312-1315
(866) 790-8027
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT20140073
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20140073
BACB
TX
Enumeration date
10/12/2020
Last updated
10/12/2020
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