Doctor Name: | MS. AMY SPONENBERG |
NPI Number: | 1184937641 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC SLP |
License Number: | SL009677 |
Business Practice Address: | 1029 Jackson St Philadelphia, PA - 19148 |
Business Phone Number: | 2672435614 |
Business Fax Number: | |
Mailing Address: | 1029 Jackson St, PHILADELPHIA |
State: | PA |
Postal Code: | 191483010 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/26/2010 |
NPI Last Update Date: | 07/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL009677 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
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 |