Individual
MS. AMANDA ELIZABETH PELLEGRINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP, TSSLD
Contact information
Practice address
8055 CORNISH AVE, ELMHURST, NY 11373-3728
(347) 738-1316
Mailing address
15840 76TH RD, FLUSHING, NY 11366-1032
(718) 591-8429
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
025086
NY
390200000X
Student in an Organized Health Care Education/Training Program
868379141
NY
Other
Enumeration date
08/25/2014
Last updated
11/29/2016
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