Individual
AMY RENFROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
13327 VITIANO CT, FORT WAYNE, IN 46845-8874
(260) 338-0876
(260) 484-3969
Mailing address
13327 VITIANO CT, FORT WAYNE, IN 46845-8874
(260) 338-0876
(260) 484-3969
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004447A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200872140
FIRST STEPS
IN
05
—
200872140
—
IN
01
—
22004447A
STATE LICENCE
IN
Enumeration date
04/24/2008
Last updated
04/24/2008
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