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Individual

AMY B EGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1024 FLORIDA AVE S, SUITE A, ROCKLEDGE, FL 32955-2152
(321) 634-3688
(321) 504-0955
Mailing address
1024 FLORIDA AVE S, SUITE A, ROCKLEDGE, FL 32955-2152
(321) 634-3688
(321) 504-0955

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
SA7094
FL
235Z00000X
Speech-Language Pathologist
Primary
SA7094
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
890245300
FL
Enumeration date
11/14/2007
Last updated
05/22/2008
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