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) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
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
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All providers in O Fallon, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2015. 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.