Individual
MRS. AMANDA BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1300 POST RD STE 204, FAIRFIELD, CT 06824-6038
(203) 255-3669
Mailing address
1300 POST RD STE 204, FAIRFIELD, CT 06824-6038
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
018076
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018076
—
NY
Enumeration date
04/08/2008
Last updated
08/06/2014
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