Individual
AMY WEATHERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 SUMMIT AVE STE 510, FORT WORTH, TX 76102-2613
(682) 730-0004
Mailing address
101 SUMMIT AVE STE 510, FORT WORTH, TX 76102-2613
(682) 730-0004
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10071
TX
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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