Individual
MRS. AMANDA JOHNSTON TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CCC/SLP
Contact information
Practice address
300 WESTWOOD ST, GLASGOW, KY 42141-1030
(270) 779-7131
Mailing address
623 PLAYERS CROSSING WAY, BOWLING GREEN, KY 42104-5534
(270) 779-7131
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2646
KY
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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