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General NPI Number Information
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NPI Number | 1962251603
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Entity Type | Individual
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Provider Name | AMANDA ATCHLEY M.S. CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 514 E WILSON ST APT B
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City | VALLIANT
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State | OK
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Zip | 74764-9115
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Country | US
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Telephone | 580-448-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 305 CLAY ST
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City | BROKEN BOW
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State | OK
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Zip | 74728-5109
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Country | US
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Telephone | 580-236-3788
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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 | CF642
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License Number State | OK
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