MEDICARE: MISS AMANDA MORRIS PITTENGER BA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant
2	222Q00000X	Developmental Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083848410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS AMANDA MORRIS PITTENGER BA

Provider Business Mailing Address
First Line	:	9854 LOPEZ DR
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-2007
Country	:	US
Telephone Number	:	813-679-9740
Fax Number	:

Provider Business Practice Location Address
First Line	:	9854 LOPEZ DR
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-2007
Country	:	US
Telephone Number	:	813-679-9740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	12/16/2025

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