MEDICARE: AMANDA M PAULEY 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	SL015242	PA

General Provider Information

NPI Number	:	1467119974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA M PAULEY CCC-SLP

Provider Business Mailing Address
First Line	:	1580 MCLAUGHLIN RUN RD STE 216
Second Line	:
City	:	UPPER ST CLAIR
State	:	PA
Zip	:	15241-3100
Country	:	US
Telephone Number	:	412-407-3539
Fax Number	:

Provider Business Practice Location Address
First Line	:	1580 MCLAUGHLIN RUN RD STE 216
Second Line	:
City	:	UPPER ST CLAIR
State	:	PA
Zip	:	15241-3100
Country	:	US
Telephone Number	:	412-407-3539
Fax Number	:

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

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	11/18/2021

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Directions to “ AMANDA M PAULEY CCC-SLP” Practice Location

Language	Start Address	Practice Location

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