Individual
AMANDA A MILLEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
74 YANK ST, COURTDALE, PA 18704-1136
(317) 726-7534
Mailing address
74 YANK ST, COURTDALE, PA 18704-1136
(317) 726-7534
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
110147
TX
235Z00000X
Speech-Language Pathologist
Primary
SL013139
PA
235Z00000X
Speech-Language Pathologist
SLP009023
GA
Other
Enumeration date
06/30/2015
Last updated
10/03/2016
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