Individual
MS. AMANDA WILLIAMS CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1904 SE 48TH AVE, PORTLAND, OR 97215-3220
(503) 577-0975
Mailing address
1904 SE 48TH AVE, PORTLAND, OR 97215-3220
(503) 577-0975
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12566
OR
Other
Enumeration date
03/07/2007
Last updated
09/15/2009
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