Individual
AMANDA RUTH POKORNICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
602 VONDERBURG DR STE 201, BRANDON, FL 33511-5900
(813) 653-1149
Mailing address
602 VONDERBURG DR STE 201, BRANDON, FL 33511-5900
(813) 653-1149
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA18098
FL
235Z00000X
Speech-Language Pathologist
SZ9087
FL
Other
Enumeration date
07/01/2019
Last updated
12/19/2021
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