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General NPI Number Information
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NPI Number | 1013256148
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Entity Type | Individual
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Provider Name | AMANDA GOODFELLOW M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 5365 HUNTERS CREEK TRL
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City | FRISCO
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State | TX
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Zip | 75034-1713
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Country | US
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Telephone | 972-505-8335
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Fax | 469-362-2954
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Provider Business Mailing Address
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Address Line | 3333 LEIGHTON RIDGE DR
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City | PLANO
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State | TX
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Zip | 75025-4396
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Country | US
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Telephone | 214-498-5350
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Fax | 469-362-2954
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 106931
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License Number State | TX
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