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NPI Code Detail

MEDICARE: AMANDA NICOLE ENDERS MSP, CCC-SLP

MEDICARE: AMANDA NICOLE ENDERS MSP, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1013325398
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA NICOLE ENDERS MSP, CCC-SLP
Provider Business Mailing Address
First Line : 267 PENWOOD LN
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-8297
Country : US
Telephone Number : 803-546-2673
Fax Number :
Provider Business Practice Location Address
First Line : 100 TARRAR SPRINGS RD
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-3835
Country : US
Telephone Number : 803-821-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2014
Last Update Date : 12/02/2019

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Directions to “ AMANDA NICOLE ENDERS MSP, CCC-SLP” Practice Location

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