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Individual

AMANDA IZEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP, TSSLD

Contact information

Practice address
48 COLBY DR, DIX HILLS, NY 11746-8348
(631) 560-5080
Mailing address
48 COLBY DR, DIX HILLS, NY 11746-8348
(631) 560-5080

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14295359
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14295359
AMERICAN SPEECH HEARING LANGUAGE ASSOCIATION
Enumeration date
05/12/2020
Last updated
05/12/2020
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