Doctor Name: | MISS AMANDA LYNN WHITE |
NPI Number: | 1871902809 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC/SLP |
License Number: | SL011415 |
Business Practice Address: | 82 N Main St Carbondale, PA - 184071914 |
Business Phone Number: | 5702820200 |
Business Fax Number: | |
Mailing Address: | 319 Vine St, BROWNDALE |
State: | PA |
Postal Code: | 184211251 |
Phone Number: | 5706776892 |
Fax Number: | |
NPI Enumeration Date: | 08/04/2014 |
NPI Last Update Date: | 08/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL011415 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
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 |