Individual
MS. AMANDA LIZETTE DE ALEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., SLP
Contact information
Practice address
159 E MAIN ST, NEW ROCHELLE, NY 10801-5760
(914) 413-7390
Mailing address
551 N COLUMBUS AVE, MOUNT VERNON, NY 10552-1332
(914) 413-7390
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
023670
NY
235Z00000X
Speech-Language Pathologist
Primary
023670-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023670-1
NYS
NY
01
—
833134141
TSSLD-BE
NY
Enumeration date
06/03/2013
Last updated
11/11/2021
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