Organization Name: | AMANDA'S SLP CARE LLC |
NPI Number: | 1457789786 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMANDA JOHNSON (OWNER) |
Mailing Address: | 8 Eagle Ctr Ste 5 O Fallon |
State: | IL US |
Postal Code: | 622691947 |
Phone Number: | 6183344550 |
Fax Number: | 8774187178 |
NPI Enumeration Date: | 10/23/2013 |
NPI Last Update Date: | 02/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.011341 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |