Most Relevant Information
Provider Data
| NPI Number: | 1003297656 |
| Provider Name: | AMBER MKINGA |
| Entity Type: | Individual |
| Taxonomy Code: | 320600000X |
| Specialty: | Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/09/2015 |
| Last Updated: | 06/09/2015 |
Provider Practice Location
165 N OLD ORCHARD LN
1212
LEWISVILLE
TX
750678973
Practice Location Phone/Fax
| Phone: | 9402935785 |
| Fax: |
Provider Mailing Location
165 N OLD ORCHARD LN
1212
LEWISVILLE
TX
750678973
Provider Mailing Phone/Fax
| Phone: | 9402935785 |
| Fax: |