Doctor Name: | AMANDA PAIGE REYNOLDS |
NPI Number: | 1316259823 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 104049 |
Business Practice Address: | 5601 Bridge St Suite 490 Fort Worth, TX - 761122384 |
Business Phone Number: | 8174465000 |
Business Fax Number: | |
Mailing Address: | 5601 Bridge St, Suite 490 FORT WORTH |
State: | TX |
Postal Code: | 761122384 |
Phone Number: | 8174465000 |
Fax Number: | |
NPI Enumeration Date: | 07/13/2010 |
NPI Last Update Date: | 07/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 104049 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |