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NPI Code Detail

MEDICARE: MRS. AMANDA DRIEDRIC MS, CCC-SLP

MEDICARE: MRS. AMANDA DRIEDRIC 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 PathologistSP#P8340AR

General Provider Information

NPI Number : 1801178314
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA DRIEDRIC MS, CCC-SLP
Provider Business Mailing Address
First Line : 109 BEAVER CREEK LN
Second Line :
City : MAUMELLE
State : AR
Zip : 72113-5938
Country : US
Telephone Number : 501-217-8600
Fax Number : 501-217-8636
Provider Business Practice Location Address
First Line : 1500 N MISSISSIPPI ST
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72207-5851
Country : US
Telephone Number : 501-208-3239
Fax Number : 501-217-8636
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2011
Last Update Date : 11/15/2023

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

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