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Individual

AMANDA MAE COFFREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
400 E ROYAL LN BLDG 3, IRVING, TX 75039-3540
(469) 249-8410
Mailing address
2700 CEDAR CREEK LN APT 1217, DENTON, TX 76210-2109
(608) 359-5861

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-63140
TX

Other

Enumeration date
11/21/2018
Last updated
11/26/2018
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