Amanda Marie Tech, M.S., CCC- SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA11900 Issued in FL

Practice address

10130 Sugar Creek Cir
Pensacola, FL 32514-1688

Phone

(850) 712-0570

NPI assigned

Apr 11, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Amanda Marie Salley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Escarosa Speech Therapy LLC

  • Speech-Language Pathologist
  • Pensacola, FL
  • NPI 1538657937
  NPD Authorized official

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669739900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 SUGAR CREEK CIR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141688",
            "telephone_number": "850-712-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 SUGAR CREEK CIR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141688",
            "telephone_number": "850-712-0570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3940 Ridgefair Dr",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300401534",
            "country_code": "US",
            "telephone_number": "850-712-0570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3940 Ridgefair Dr",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300401534",
            "country_code": "US",
            "telephone_number": "850-712-0570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TECH",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC- SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009604",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ5421",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SALLEY",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "M.S., CF-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.