Individual
MRS. AMANDA MARIE BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LIC./CCC-SLP
Contact information
Practice address
2592 STATE ROUTE 3, FULTON, NY 13069-4852
(315) 593-5570
Mailing address
8162 AVOSS LN, CLAY, NY 13041-8965
(315) 593-5570
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
020261-1
NY
Other
Enumeration date
10/11/2011
Last updated
10/23/2014
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