Individual
KELLY MCCULLOCH AMATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
2618 CHANCER DR, HENRICO, VA 23233-2133
(804) 943-3919
Mailing address
2618 CHANCER DR, HENRICO, VA 23233-2133
(804) 943-3919
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
08682
MD
235Z00000X
Speech-Language Pathologist
SA10929
FL
Other
Enumeration date
04/20/2011
Last updated
02/06/2018
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