Provider Demographics
NPI:1912673914
Name:VARNON, AMANDA SHEARER
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:SHEARER
Last Name:VARNON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 TRINITY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3988
Mailing Address - Country:US
Mailing Address - Phone:281-793-7828
Mailing Address - Fax:
Practice Address - Street 1:4303 TRINITY CREEK CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3988
Practice Address - Country:US
Practice Address - Phone:281-793-7828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional