Individual
MRS. AMY KENNEDY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
22 LAKE BEAUTY DR, SUITE 304, ORLANDO, FL 32806-2037
(407) 924-5430
Mailing address
2518 CHIPPEWA TRL, MAITLAND, FL 32751-4045
(407) 924-5430
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 8916
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890769200
—
FL
01
—
SA 8916
STATE LICENSE NUMBER
FL
Enumeration date
02/21/2007
Last updated
03/12/2013
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