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General NPI Number Information
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NPI Number | 1790266831
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Entity Type | Organization
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Legal Business Name | AMANDA D'AUGUSTINO, MS, CCC-SLP
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 9607 NW 49TH CT
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City | SUNRISE
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State | FL
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Zip | 33351-5105
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Country | US
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Telephone | 954-648-7375
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Fax |
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Provider Business Mailing Address
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Address Line | 9607 NW 49TH CT
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City | SUNRISE
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State | FL
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Zip | 33351-5105
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Country | US
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Telephone | 954-648-7375
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMANDA D'AUGUSTINO
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Credential | MS, CCC-SLP
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Telephone | 954-648-7375
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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 | SA15700
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License Number State | FL
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