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NPI Code Detail

MEDICARE: AMY PEABODY

MEDICARE:   AMY  PEABODY
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 Pathologist2010014297MO

General Provider Information

NPI Number : 1821384835
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY PEABODY
Provider Business Mailing Address
First Line : 410 W BENTON ST
Second Line :
City : MONETT
State : MO
Zip : 65708-1608
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 410 W BENTON ST
Second Line :
City : MONETT
State : MO
Zip : 65708-1608
Country : US
Telephone Number : 417-235-3049
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2011
Last Update Date : 06/28/2011

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Directions to “ AMY PEABODY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.