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General NPI Number Information
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NPI Number | 1972940369
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Entity Type | Individual
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Provider Name | AMANDA CLARK WRIGHT CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/27/2013
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Last Update Date | 05/27/2013
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Provider Practice Location Address
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Address Line | 8000 MARTIN LUTHER KING JR BLVD
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City | PARIS
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State | KY
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Zip | 40361-2157
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Country | US
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Telephone | 859-987-2106
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Fax |
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Provider Business Mailing Address
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Address Line | 2984 MAHALA LN
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City | LEXINGTON
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State | KY
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Zip | 40509-8555
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Country | US
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Telephone | 606-205-9094
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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 | 3827
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License Number State | KY
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