Individual
MRS. AMANDA JANE BRODBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 1 BOX 68A, BATCHTOWN, IL 62006-9711
(618) 396-7304
Mailing address
RR 1 BOX 68A, BATCHTOWN, IL 62006-9711
(618) 396-7304
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146008394
IL
235Z00000X
Speech-Language Pathologist
2005032382
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467508008
—
MO
Enumeration date
03/20/2007
Last updated
06/28/2016
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