MEDICARE: AMANDA CIPPERLY M.S. 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
1	235Z00000X	Speech-Language Pathologist	026764	NY

General Provider Information

NPI Number	:	1134658776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA CIPPERLY M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	1104 ARBOR HILL RD
Second Line	:
City	:	DELHI
State	:	NY
Zip	:	13753-2208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 ARBOR HILL RD
Second Line	:
City	:	DELHI
State	:	NY
Zip	:	13753-2208
Country	:	US
Telephone Number	:	607-746-4240
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2017
Last Update Date	:	08/18/2023

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Directions to “ AMANDA CIPPERLY M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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