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General NPI Number Information
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NPI Number | 1598993081
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Entity Type | Individual
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Provider Name | AMANDA KAYE SIMPSON MA SLP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 701 WISCONSIN AVE
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City | STREATOR
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State | IL
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Zip | 61364-2436
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Country | US
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Telephone | 815-672-1686
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Fax | 815-672-1686
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Provider Business Mailing Address
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Address Line | 701 4TH AVE
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City | MENDOTA
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State | IL
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Zip | 61342
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Country | US
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Telephone | 815-674-9294
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Fax | 815-672-1686
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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 | 146.006517
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License Number State | IL
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