Individual
MICHELLE AMENTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
95 S RIDGE LN, BERLIN, CT 06037
(860) 785-4378
Mailing address
PO BOX 942, ROCKY HILL, CT 06067-0942
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
003560
CT
235Z00000X
Speech-Language Pathologist
015510
OR
235Z00000X
Speech-Language Pathologist
015546
NY
235Z00000X
Speech-Language Pathologist
24154
CA
235Z00000X
Speech-Language Pathologist
7101004881
MI
Other
Enumeration date
05/24/2013
Last updated
05/19/2018
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