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General NPI Number Information
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NPI Number | 1750970943
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Entity Type | Individual
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Provider Name | AMBER CLINE CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/13/2021
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 1002 GLENVIEW DR
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City | GLASGOW
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State | KY
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Zip | 42141-3424
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Country | US
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Telephone | 270-651-8332
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Fax |
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Provider Business Mailing Address
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Address Line | 216 BAKER ST
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City | EDMONTON
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State | KY
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Zip | 42129-9402
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Country | US
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Telephone | 270-590-6841
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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 | 266960
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License Number State | KY
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