Doctor Name: | MRS. AMANDA DANIELLE LONG |
NPI Number: | 1144667718 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. CCC-SLP |
License Number: | SLP008055 |
Business Practice Address: | 1094 Eisenhower Dr Ste A Savannah, GA - 314062602 |
Business Phone Number: | 9123351650 |
Business Fax Number: | |
Mailing Address: | 6 Gables Dr, POOLER |
State: | GA |
Postal Code: | 313229693 |
Phone Number: | 9126676468 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2013 |
NPI Last Update Date: | 05/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP008055 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |