MEDICARE: ROBYN AMENDOLA

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	235Z00000X	Speech-Language Pathologist	06644	MD

General Provider Information

NPI Number	:	1194126011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN AMENDOLA

Provider Business Mailing Address
First Line	:	11908 BRISTOL MANOR CT
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-5804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11908 BRISTOL MANOR CT
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-5804
Country	:	US
Telephone Number	:	301-881-1394
Fax Number	:

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

Provider Enumeration Date	:	09/10/2014
Last Update Date	:	09/10/2014

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Directions to “ ROBYN AMENDOLA ” Practice Location

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