Provider Demographics
NPI:1265734826
Name:ZOLD, AMANDA LYNN (PHD)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYNN
Last Name:ZOLD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:2800 S MACGREGOR WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-1032
Mailing Address - Country:US
Mailing Address - Phone:713-741-5000
Mailing Address - Fax:713-741-6909
Practice Address - Street 1:5615 H. MARK CROSSWELL JR. ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021
Practice Address - Country:US
Practice Address - Phone:860-545-7341
Practice Address - Fax:860-545-7510
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT3989103TC0700X
171M00000X
TX39433103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator