MEDICARE: MRS. AMANDA ANN WHITAKER 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
1	235Z00000X	Speech-Language Pathologist	14259644-4102	UT

General Provider Information

NPI Number	:	1740954874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA ANN WHITAKER MS, CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 2446
Second Line	:
City	:	RUNNING SPRINGS
State	:	CA
Zip	:	92382-2446
Country	:	US
Telephone Number	:	909-672-0969
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 W 1425 N
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-8872
Country	:	US
Telephone Number	:	435-267-1700
Fax Number	:

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

Provider Enumeration Date	:	08/03/2021
Last Update Date	:	05/26/2026

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Directions to “ MRS. AMANDA ANN WHITAKER MS, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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