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NPI Code Detail

MEDICARE: MRS. AMANDA LEE M.A. CCC-SLP

MEDICARE:  MRS. AMANDA  LEE  M.A. 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 Pathologist110225TX

General Provider Information

NPI Number : 1417313495
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA LEE M.A. CCC-SLP
Provider Business Mailing Address
First Line : 10130 GRANT RD
Second Line : SUITE. #218
City : HOUSTON
State : TX
Zip : 77070-4531
Country : US
Telephone Number : 281-807-6325
Fax Number :
Provider Business Practice Location Address
First Line : 10130 GRANT RD
Second Line : SUITE. #218
City : HOUSTON
State : TX
Zip : 77070-4531
Country : US
Telephone Number : 281-807-6325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2016
Last Update Date : 03/16/2020

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Directions to “ MRS. AMANDA LEE M.A. CCC-SLP” Practice Location

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