Individual
MRS. AMY MAYME VANGORP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS-CCC/SLP
Contact information
Practice address
960 SALT SPRINGS RD, SYRACUSE, NY 13224-1639
(315) 446-3220
Mailing address
628 LAKEPORT RD, CHITTENANGO, NY 13037-1317
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
012452
NY
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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