Individual
MRS. AMENTHIA MEREDITH KOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1417 AUGUSTA DR, SAVANNAH, TX 76227-7663
(214) 546-8382
Mailing address
1417 AUGUSTA DR, SAVANNAH, TX 76227-7663
(214) 546-8382
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
106038
TX
235Z00000X
Speech-Language Pathologist
SP698
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106038
TEXAS SPEECH PATHOLOGY LICENSE
TX
05
—
106038
—
TX
05
—
121468721
—
AR
01
—
5T451
BLUECROSS
AR
Enumeration date
03/23/2007
Last updated
01/16/2019
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