| NPI | 1669034385 |
|---|---|
| Former Name | AMANDA FELIZ DAVIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM SWB-2022-0987) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M-10800) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2025-08-28 |