Provider Demographics
NPI:1073360152
Name:MORRIS, AMANDA ARGUELLO (RDN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ARGUELLO
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CAMDEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-0256
Mailing Address - Country:US
Mailing Address - Phone:504-495-0688
Mailing Address - Fax:
Practice Address - Street 1:555 CAMDEN PARK DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70435-0256
Practice Address - Country:US
Practice Address - Phone:504-495-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2586133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered