Amanda S Worden, SLP
Individual provider Active NPI Speech-Language Pathologist · Moravia, NY
NPI 1710173455 · NPPES record last updated Oct 13, 2010
Key facts
- NPI
- 1710173455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 24 S Main St
Moravia, NY 13118-2307 - Phone
- (315) 497-2670
- Fax
- (315) 497-3961
- NPI assigned
- Sep 17, 2007
- Sex
- Female
- Sole proprietor
- No
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moravia Central School District | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
24 S Main St
Moravia, NY 13118-2307
Mailing address
68 S Main St
PO Box 1188
Moravia, NY 13118-2310
Phone (315) 497-2670
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018312-1 | Other | NY | SLP LICENSE NUMBER |
| 16903813 | Other | NY | NYS TEACHER CERTIFICATE |
Other names
- Amanda M Soprano
Other providers in Moravia, NY
All providers in Moravia, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2010. 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.