Individual
AMANDA JEAN PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
128 E OLIN AVE, MADISON, WI 53713-1467
(608) 252-1320
(608) 252-1333
Mailing address
7201 RANCH ROAD 2222 APT 1318, AUSTIN, TX 78730-3214
(224) 703-1824
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
116037
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6093
WI DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
08/07/2020
Last updated
11/17/2022
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