Provider Demographics
NPI:1538812193
Name:DAY, AMANDA (RCP,CRT)
Entity type:Individual
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First Name:AMANDA
Middle Name:
Last Name:DAY
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Gender:F
Credentials:RCP,CRT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4900 TRAIL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6525
Mailing Address - Country:US
Mailing Address - Phone:817-939-3462
Mailing Address - Fax:817-562-2048
Practice Address - Street 1:1920 E STATE HIGHWAY 114
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6510
Practice Address - Country:US
Practice Address - Phone:855-636-5486
Practice Address - Fax:817-562-2048
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXRCP000736142278H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome Health