Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 11292 | TX |
N | 111NN1001X | Nutrition | 11292 | TX |
N | 111NP0017X | Pediatric Chiropractor | 11292 | TX |
NPI | 1013246362 |
---|---|
Provider Name | Amanda Golden |
First Address | Humble, TX 77346-2384 |
Second Address | Splendora, TX 77372-4698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2009 |
Last Update Date | 05/02/2011 |