Individual
AMANDA LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1611 HEADWAY CIR, AUSTIN, TX 78754-5160
(512) 615-7123
Mailing address
816 SHERATON AVE, AUSTIN, TX 78745-2044
(979) 885-9785
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
104483
TX
Other
Enumeration date
06/25/2009
Last updated
06/25/2009
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