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NPI Code Detail

MEDICARE: AMANDA REDLER MS CCC-SLP

MEDICARE: AMANDA REDLER MS CCC-SLP
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
1235Z00000XSpeech-Language Pathologist6159MA

General Provider Information

NPI Number : 1376681940
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA REDLER MS CCC-SLP
Provider Business Mailing Address
First Line : 57 TAFT AVE
Second Line :
City : NEWTON
State : MA
Zip : 02465-1325
Country : US
Telephone Number : 617-264-0977
Fax Number :
Provider Business Practice Location Address
First Line : 101 VANDERBILT AVE
Second Line :
City : NORWOOD
State : MA
Zip : 02062-5011
Country : US
Telephone Number : 781-551-0405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2007
Last Update Date : 09/21/2010

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Directions to “ AMANDA REDLER MS CCC-SLP” Practice Location

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