Individual
AMANDA DOLATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
489 DEVON PARK DR STE 301, WAYNE, PA 19087-1809
(484) 367-7131
Mailing address
4860 SMICK ST, PHILADELPHIA, PA 19127-1911
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL013100
PA
Other
Enumeration date
02/10/2019
Last updated
02/10/2019
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