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NPI 1164338018

NPI 1164338018 : AMANDA HER M.S., CCC-SLP : MODESTO, CA

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General NPI Number Information
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    NPI Number           |    1164338018
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA HER M.S., CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/20/2026
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    Last Update Date     |    08/20/2026
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Provider Practice Location Address
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    Address Line         |    909 GLENN AVE 
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    City                 |    MODESTO
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    State                |    CA
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    Zip                  |    95358-6010
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    Country              |    US
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    Telephone            |    209-574-1952
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    426 LOCUST ST 
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    City                 |    MODESTO
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    State                |    CA
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    Zip                  |    95351-2699
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    Country              |    US
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    Telephone            |    209-574-1500
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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       |    35750
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    License Number State |    CA
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