Basic Information
| Provider Information | |||||||||
| NPI: | 1891970786 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHULTZ | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MS/CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 128 S CAROLINA LN | ||||||||
| Address2: | |||||||||
| City: | NEW FLORENCE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159442442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613026745 | ||||||||
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| Practice Location | |||||||||
| Address1: | 50 N MALIN RD | ||||||||
| Address2: | |||||||||
| City: | BROOMALL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190081429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103560800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2008 | ||||||||
| LastUpdateDate: | 01/09/2008 | ||||||||
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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 | SL008324 | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.