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General NPI Number Information
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NPI Number | 1831733419
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Entity Type | Individual
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Provider Name | AMANDA BETH FAMBROUGH
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Gender | Female
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 1012 24TH AVE NW
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City | NORMAN
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State | OK
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Zip | 73069-6490
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Country | US
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Telephone | 56-014-3034
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 892373
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City | OKLAHOMA CITY
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State | OK
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Zip | 73189-2373
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Country | US
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Telephone | 405-601-4303
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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 | CF548
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 6199
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License Number State | OK
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