Healthcare Provider Details

I. General information

NPI: 1649433095
Provider Name (Legal Business Name): AMY BETH MEINZER MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 RISEN SON BLVD
COUNCIL BLUFFS IA
51503-1911
US

IV. Provider business mailing address

1105 HARNEY ST APT 407
OMAHA NE
68102-1829
US

V. Phone/Fax

Practice location:
  • Phone: 712-366-9655
  • Fax: 712-366-0277
Mailing address:
  • Phone: 402-415-1406
  • Fax: 712-366-0277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number00934
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number618
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: