Individual
AMANDA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
7830 PINE FOREST RD, PENSACOLA, FL 32526-8404
(850) 741-6715
(850) 204-0489
Mailing address
922 E BOBE ST, PENSACOLA, FL 32503-3962
(850) 741-6715
(850) 204-0489
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2975
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14033060
ASHA
AR
Enumeration date
02/23/2017
Last updated
11/21/2022
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