Basic Information
| Provider Information | |||||||||
| NPI: | 1649887308 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DURAN | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | DON | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 514 JENNY PL | ||||||||
| Address2: | |||||||||
| City: | DALHART | ||||||||
| State: | TX | ||||||||
| PostalCode: | 790225400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8068845106 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1411 DENVER AVE | ||||||||
| Address2: | |||||||||
| City: | DALHART | ||||||||
| State: | TX | ||||||||
| PostalCode: | 790224809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8062444571 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2020 | ||||||||
| LastUpdateDate: | 09/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 103273 | TX | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.