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General NPI Number Information
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NPI Number | 1255644266
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Entity Type | Individual
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Provider Name | AMANDA BRIDGES MAXWELL M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 1025 23RD ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35205-2499
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Country | US
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Telephone | 205-870-4241
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Fax |
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Provider Business Mailing Address
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Address Line | 2209 COMER PL
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City | VESTAVIA
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State | AL
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Zip | 35216-2030
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Country | US
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Telephone | 205-870-4241
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Fax | 205-320-4984
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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 | 3077
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License Number State | AL
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