Healthcare Provider Details

I. General information

NPI: 1740954874
Provider Name (Legal Business Name): AMANDA ANN WHITAKER MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W 1425 N
CEDAR CITY UT
84721-8872
US

IV. Provider business mailing address

PO BOX 2446
RUNNING SPRINGS CA
92382-2446
US

V. Phone/Fax

Practice location:
  • Phone: 435-267-1700
  • Fax:
Mailing address:
  • Phone: 909-672-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14259644-4102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: