Individual
MRS. AMANDA CELESTE BENES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1777 NORTHEAST EXPY NE STE 120, BROOKHAVEN, GA 30329-2475
(404) 228-8558
(855) 242-2110
Mailing address
3125 BROOK DR, DECATUR, GA 30033-3911
(330) 696-7802
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009540
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
581990269
—
GA
Enumeration date
02/15/2018
Last updated
08/16/2023
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