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General NPI Number Information
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NPI Number | 1376041947
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Entity Type | Individual
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Provider Name | AMANDA CHARLEE ABNER CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 2705 REBECCA LN STE B
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City | ORANGE CITY
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State | FL
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Zip | 32763-8336
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Country | US
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Telephone | 386-532-8255
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Fax |
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Provider Business Mailing Address
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Address Line | 25345 SAINT ANNE ST
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City | SORRENTO
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State | FL
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Zip | 32776-9669
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Country | US
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Telephone | 386-747-2495
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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 | SZ8467
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License Number State | FL
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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 | 29518
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License Number State | CA
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