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General NPI Number Information
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NPI Number | 1114179488
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Entity Type | Individual
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Provider Name | AMY S SOULE CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/18/2008
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 99 MAIN ST
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City | DELHI
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State | NY
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Zip | 13753-1221
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Country | US
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Telephone | 607-832-5200
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Fax | 607-832-5202
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Provider Business Mailing Address
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Address Line | 56225 STATE HIGHWAY 10
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City | BLOOMVILLE
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State | NY
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Zip | 13739-2154
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Country | US
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Telephone | 607-287-9144
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Fax |
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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 | 017962-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 10966
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License Number State | NC
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