Individual
AMANDA M BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD, CCC-A
Contact information
Practice address
1000 W NIFONG BLVD, BUILDING 3, SUITE 100, COLUMBIA, MO 65203-5615
(573) 214-2000
(573) 214-2042
Mailing address
1000 W NIFONG BLVD, BUILDING 3, SUITE 100, COLUMBIA, MO 65203-5615
(573) 214-2000
(573) 214-2042
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2011017513
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011017513
LICENSE ISSUED BY THE STATE OF MISSOURI
MO
Enumeration date
06/16/2011
Last updated
06/16/2011
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