Amanda'S SLP Care LLC

Organization Active NPI Speech-Language Pathologist · O Fallon, IL

NPI 1457789786 · NPPES record last updated Feb 27, 2015

Key facts

NPI
1457789786
Entity type
Organization (NPI type 2)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146.011341 (IL)
Legal business name
AMANDA'S SLP CARE LLC
Practice address
8 Eagle Ctr Ste 5
O Fallon, IL 62269-1947
Phone
(618) 334-4550
Fax
(877) 418-7178
NPI assigned
Oct 23, 2013
Organization subpart
No

Authorized official

Name
Amanda Johnson, MS,CCC-SLP
Title
Owner
Phone
(618) 334-4550

National Provider Directory

Locations

8 Eagle Ctr
Ste 5
O Fallon, IL 62269
Phone (618) 334-4550

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
235Z00000X 146.011341 IL Yes

Addresses

Primary practice location

8 Eagle Ctr Ste 5
O Fallon, IL 62269-1947

Mailing address

8 Eagle Ctr Ste 5
O Fallon, IL 62269-1947
Phone (618) 334-4550

Other providers in O Fallon, IL

All providers in O Fallon, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.