Individual
AMY MARY PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
30 WEST ST, GENEVA, NY 14456-2521
(315) 781-0406
Mailing address
37 ANGELO ST, GENEVA, NY 14456-1013
(315) 789-5825
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
010518-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010518-1
SPEECH-LANGUAGE PATHOLOGIST LICENSE
NY
01
—
12024660
CCC-SLP
NY
Enumeration date
12/16/2011
Last updated
12/16/2011
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