Individual
MS. AMY ELIZABETH IMKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
7107 SW VIRGINIA AVE, PORTLAND, OR 97219-3034
(310) 947-4180
Mailing address
7107 SW VIRGINIA AVE, PORTLAND, OR 97219-3034
(310) 947-4180
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13348
OR
235Z00000X
Speech-Language Pathologist
SP15889
CA
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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