Individual
AMBER MANSARAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2104 GREENBRIAR DR, SOUTHLAKE, TX 76092-8355
(817) 442-9022
Mailing address
301 WILCREST DR APT 7703, HOUSTON, TX 77042-1072
(951) 551-7281
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-102703
TX
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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