Individual
AMANDA LOUISE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
701 WILLOW ST, PESHTIGO, WI 54157-1165
(715) 582-3962
Mailing address
379 CHASE AVE, DE PERE, WI 54115-4053
(920) 819-2933
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2377-154
WI
Other
Enumeration date
05/15/2007
Last updated
01/31/2019
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