Basic Information
| Provider Information | |||||||||
| NPI: | 1770897100 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DEMPSEY | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 FARMINGTON DR | ||||||||
| Address2: | |||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750021566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174330721 | ||||||||
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| Practice Location | |||||||||
| Address1: | 915 W EXCHANGE PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750137017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145471571 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2010 | ||||||||
| LastUpdateDate: | 07/27/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 17770 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | 149984001 | 05 | TX | MEDICAID |