| NPI | 1780948729 |
|---|---|
| Former Name | AMANDA MOODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: SC 5342) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: AZ TSLP7816) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2013-09-03 |