| Doctor Name: | AMANDA SUSAN MARINE |
| NPI Number: | 1710124177 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ST |
| License Number: | 001851 |
| Business Practice Address: | 612 8th St Sw Altoona, IA - 500092301 |
| Business Phone Number: | 5159674124 |
| Business Fax Number: | 5159679094 |
| Mailing Address: | Po Box 461, NEVADA |
| State: | IA |
| Postal Code: | 502010461 |
| Phone Number: | 5153823366 |
| Fax Number: | 5153821576 |
| NPI Enumeration Date: | 01/07/2009 |
| NPI Last Update Date: | 01/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 001851 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| 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 |