Individual
AMANDA SUSAN MARINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
612 8TH ST SW, ALTOONA, IA 50009-2301
(515) 967-4124
(515) 967-9094
Mailing address
PO BOX 461, NEVADA, IA 50201-0461
(515) 382-3366
(515) 382-1576
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
001851
IA
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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