Individual
MRS. AMANDA PERICLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
8848 RED OAK BLVD STE AA, CHARLOTTE, NC 28217-5595
(980) 422-5887
Mailing address
8848 RED OAK BLVD STE AA, CHARLOTTE, NC 28217-5595
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
2355S0801X
Speech-Language Assistant
SP1126-SA
MA
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/21/2015
Last updated
06/14/2022
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