| Doctor Name: | MRS. AMANDA WILSON SCANLON |
| NPI Number: | 1225089485 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCCSLP |
| License Number: | 2202002582 |
| Business Practice Address: | 719 Jackson St Roanoke Rapids, NC - 278702605 |
| Business Phone Number: | 2525355712 |
| Business Fax Number: | 2525355712 |
| Mailing Address: | 719 Jackson St, ROANOKE RAPIDS |
| State: | NC |
| Postal Code: | 278702605 |
| Phone Number: | 2525355712 |
| Fax Number: | 2525355712 |
| NPI Enumeration Date: | 05/13/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202002582 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| 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 |