Amg Speech Therapy LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

AMG SPEECH THERAPY LLC

Practice address

9217 Brayden Bay St
Las Vegas, NV 89178-9311

Phone

(650) 564-4352

NPI assigned

Jan 15, 2025

Last updated

Jan 15, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Audrey Lynn Gillman, MS, CCC-SLPNPI 1548735210

Title

Ceo

Phone

(650) 564-4352

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Audrey Lynn Manalang Gillman, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Las Vegas, NV
  • NPI 1548735210
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1194536490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9217 BRAYDEN BAY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891789311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9217 BRAYDEN BAY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891789311",
            "telephone_number": "650-564-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "GILLMAN",
        "authorized_official_first_name": "AUDREY LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-564-4352",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Speech-Language Pathologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.