Individual
MRS. AMANDA JAIME FAZAKERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2521 STOCKTON BLVD STE 6201, SACRAMENTO, CA 95817-2207
(916) 734-5400
Mailing address
2521 STOCKTON BLVD STE 4300, SACRAMENTO, CA 95817-2207
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
23667
CA
Other
Enumeration date
05/30/2017
Last updated
12/10/2018
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