MEDICARE: AMY LOUISE SAMPLE PAPPALARDO 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
1	235Z00000X	Speech-Language Pathologist	8214	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8214	OTHER	NC	STATE LICENSURE NUMBER
2	12117153	OTHER		ASHA ASSOC. NUMBER

General Provider Information

NPI Number	:	1447566138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LOUISE SAMPLE PAPPALARDO CCC-SLP

Provider Business Mailing Address
First Line	:	5721 BAYLEAF LN
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1262
Country	:	US
Telephone Number	:	336-392-7775
Fax Number	:

Provider Business Practice Location Address
First Line	:	5721 BAYLEAF LN
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1262
Country	:	US
Telephone Number	:	336-392-7775
Fax Number	:

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

Provider Enumeration Date	:	08/19/2010
Last Update Date	:	04/15/2026

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Directions to “ AMY LOUISE SAMPLE PAPPALARDO CCC-SLP” Practice Location

Language	Start Address	Practice Location

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