Individual
AMANDA S WORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
24 S MAIN ST, MORAVIA, NY 13118-2307
(315) 497-2670
(315) 497-3961
Mailing address
68 S MAIN ST, PO BOX 1188, MORAVIA, NY 13118-2310
(315) 497-2670
(315) 497-3961
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018312-1
SLP LICENSE NUMBER
NY
01
—
16903813
NYS TEACHER CERTIFICATE
NY
Enumeration date
09/17/2007
Last updated
10/13/2010
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