Amanda Cormier

Individual provider Active NPI Speech-Language Pathologist · Beaumont, TX

NPI 1962800201 · NPPES record last updated Dec 19, 2014

Key facts

NPI
1962800201
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
106295 (TX)
Practice address
1020 S 23Rd St
Beaumont, TX 77707-4202
Phone
(409) 842-9700
NPI assigned
Dec 19, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
106295TXMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 106295 TX Yes

Addresses

Primary practice location

1020 S 23Rd St
Beaumont, TX 77707-4202

Mailing address

17985 Magnolia Dr
Beaumont, TX 77705-8553

Other providers in Beaumont, TX

All providers in Beaumont, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.