Amanda Arbogast, M.S, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Canton, GA
NPI 1497364806 · NPPES record last updated Jul 31, 2020
Key facts
- NPI
- 1497364806
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 16517 (FL)
- Practice address
- 610 Royal Crest Court
Canton, GA 30115 - Phone
- (678) 827-6727
- NPI assigned
- Jul 31, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16517 | FL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cobblestone Pathways, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 16517 | FL | Yes |
Addresses
Primary practice location
610 Royal Crest Court
Canton, GA 30115
Mailing address
610 Royal Crest CT
Canton, GA 30115-1835
Phone (954) 599-3031
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All providers in Canton, 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 Jul 31, 2020. 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.