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NPI 1427483635

NPI 1427483635 : AMANDA KAY RECKER M.S., CCC-SLP : OTTAWA, OH

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General NPI Number Information
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    NPI Number           |    1427483635
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA KAY RECKER M.S., CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/06/2013
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    Last Update Date     |    09/06/2013
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Provider Practice Location Address
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    Address Line         |    1331 E 4TH ST 
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    City                 |    OTTAWA
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    State                |    OH
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    Zip                  |    45875-1505
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    Country              |    US
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    Telephone            |    419-523-9337
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 152 
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    City                 |    KALIDA
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    State                |    OH
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    Zip                  |    45853-0152
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    Country              |    US
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    Telephone            |    419-796-0386
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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       |    9632
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    License Number State |    OH
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