Individual
MS. AMY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SLP
Contact information
Practice address
1731 INTERLAKE DR, WANTAGH, NY 11793-3503
(516) 826-3107
Mailing address
1731 INTERLAKE DR, WANTAGH, NY 11793-3503
(516) 826-3107
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
012575-1
NY
Other
Enumeration date
10/16/2014
Last updated
10/16/2014
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