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Individual

AMANDA GESOURAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA CF-SLP

Contact information

Practice address
3474 E LIVINGSTON AVE, COLUMBUS, OH 43227-2219
(614) 324-4585
Mailing address
3474 E LIVINGSTON AVE, COLUMBUS, OH 43227-2219
(614) 324-4585

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
COND.20211778-SP
OH
235Z00000X
Speech-Language Pathologist
Primary
SP.14925
OH

Other

Enumeration date
09/01/2021
Last updated
08/29/2022
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