Samantha T Amtmann
Individual provider Active NPI Speech-Language Pathologist · Fayetteville, GA
NPI 1407532112 · NPPES record last updated Jun 26, 2023
Key facts
- NPI
- 1407532112
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP012597 (GA)
- Practice address
- 175 Carnegie PL Ste 137
Fayetteville, GA 30214-7903 - Phone
- (770) 719-8840
- NPI assigned
- Jun 26, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP012597 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Child'S Therapy, Inc | Speech-Language Pathologist | Past | Accepting new patients |
| Verbal Concepts | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP012597 | GA | Yes |
Addresses
Primary practice location
175 Carnegie PL Ste 137
Fayetteville, GA 30214-7903
Mailing address
1018 Lullwater Cir
Newnan, GA 30263-5899
Other providers in Fayetteville, GA
- American Health Imaging of Georgia LLC
- Uwa Kalu Amoji
- Amor Home Care LLC
- Karen Denise Amos
- Oyeyemi Kikelomo Amosu
- Young H An
- Eucharia Nkechi Anachebe
- Dianna Marie Anderson
- Emma Day Anderson
- Kyra Anderson
All providers in Fayetteville, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.