Amanita Luba Brazil, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL010044 Issued in PA

Practice address

68 W Donegal St
Mount Joy, PA 17552-2220

Phone

(814) 450-3012

NPI assigned

Jul 29, 2010

Last updated

Jul 29, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1336453539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 W DONEGAL ST",
            "city": "MOUNT JOY",
            "state": "PA",
            "postal_code": "175522220",
            "telephone_number": "814-450-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 W DONEGAL ST",
            "city": "MOUNT JOY",
            "state": "PA",
            "postal_code": "175522220",
            "telephone_number": "814-450-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZIL",
        "first_name": "AMANITA",
        "middle_name": "LUBA",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL010044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Mount Joy, PA
• Providers in Mount Joy, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.