Doctor Name: | MRS. AMANDA MARIE CHAMPION |
NPI Number: | 1841270279 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | 146008397 |
Business Practice Address: | 6501 N Sheridan Rd Peoria, IL - 61614 |
Business Phone Number: | 3096928670 |
Business Fax Number: | 3096928673 |
Mailing Address: | 600 S 13th Street, PEKIN |
State: | IL |
Postal Code: | 61554 |
Phone Number: | 3093530382 |
Fax Number: | 3093473529 |
NPI Enumeration Date: | 01/20/2006 |
NPI Last Update Date: | 10/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146008397 |
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 |