Basic Information
| Provider Information | |||||||||
| NPI: | 1710276142 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | AMANDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1529 N PINE ST | ||||||||
| Address2: | |||||||||
| City: | MARSHFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657062422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4172747874 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 STATE HIGHWAY DD | ||||||||
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| City: | MARSHFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657061513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178592120 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2011 | ||||||||
| LastUpdateDate: | 10/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2011004664 | MO | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.