Individual
MISS AMANDA TAHEREH POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 W SAN MARCOS BLVD STE 108, SAN MARCOS, CA 92078-1116
(760) 510-6910
Mailing address
1668 MILAN WAY, SAN MARCOS, CA 92078-1084
(760) 519-1523
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
20139
CA
Other
Enumeration date
07/10/2018
Last updated
02/06/2025
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