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General NPI Number Information
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NPI Number | 1821372657
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Entity Type | Individual
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Provider Name | AMANDA KAY BOUR M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 1700 E SANDUSKY ST
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City | FINDLAY
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State | OH
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Zip | 45840-6463
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Country | US
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Telephone | 419-425-7073
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Fax |
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Provider Business Mailing Address
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Address Line | 1985 JAMIE DR
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City | FINDLAY
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State | OH
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Zip | 45840-1430
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Country | US
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Telephone | 419-309-0012
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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 | 4360548
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License Number State | OH
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