Provider Demographics
NPI:1912548843
Name:LAFRENZ, AMANDA N (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:LAFRENZ
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GREENTHREAD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5419
Mailing Address - Country:US
Mailing Address - Phone:956-371-3481
Mailing Address - Fax:
Practice Address - Street 1:23 HOSPITAL DR STE 102
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5270
Practice Address - Country:US
Practice Address - Phone:325-238-9337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBACB528513106S00000X
1-21-56107103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician