Individual
AMANDA CASILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
2222 E HIGHLAND AVE STE 204, PHOENIX, AZ 85016-4876
(602) 264-4834
(602) 254-5178
Mailing address
2222 E HIGHLAND AVE, STE 204, PHOENIX, AZ 85016-4876
(602) 476-5008
(602) 257-8319
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
80781
TX
231H00000X
Audiologist
Primary
DA10971
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA10971
LICENSE
AZ
Enumeration date
04/24/2017
Last updated
10/30/2018
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