Individual
MRS. AMANDA RENEE NORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
4803 HORSEMAN DR NE, ROANOKE, VA 24019-5642
(765) 437-4976
Mailing address
4803 HORSEMAN DR NE, ROANOKE, VA 24019-5642
(765) 437-4976
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22005045A
IN
235Z00000X
Speech-Language Pathologist
Primary
2202008092
VA
235Z00000X
Speech-Language Pathologist
4168-154
WI
235Z00000X
Speech-Language Pathologist
9511
MN
Other
Enumeration date
07/07/2015
Last updated
11/27/2023
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