Individual
MISS AMANDA L GILBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC, BCBA
Contact information
Practice address
222 REDBANK RD, GOOSE CREEK, SC 29445
(843) 628-2935
(843) 628-2935
Mailing address
P.O. BX 1667, GOOSE CREEK, SC 29445
(843) 628-2935
(843) 628-2935
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-10-7083
SC
103K00000X
Behavior Analyst
1-10-7083
—
235Z00000X
Speech-Language Pathologist
Primary
4183
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4183
—
SC
Enumeration date
04/29/2009
Last updated
06/13/2012
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