Healthcare Provider Details

I. General information

NPI: 1780867424
Provider Name (Legal Business Name): AMY ELIZABETH CAMERON MA, CCC-SP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 SALEM TOWNE CT
APEX NC
27502-2311
US

IV. Provider business mailing address

103 SALEM TOWNE CT
APEX NC
27502-2311
US

V. Phone/Fax

Practice location:
  • Phone: 919-387-1818
  • Fax: 919-387-1818
Mailing address:
  • Phone: 919-387-1818
  • Fax: 919-387-1818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5363
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: