National Provider Identifier

Amanda L Johannssen, CCC-SLP

Amanda L Johannssen, CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Rochester, NY and a listed phone number of (315) 717-9191.

NPI 1043571433Rochester, NYSpeech-Language Pathologist

Profile Overview

NPI
1043571433
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
June 03, 2012
Last Updated
June 03, 2012

Practice Location

  • 109 Troup St
  • Rochester, NY 14608-2027

Phone: (315) 717-9191

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1043571433
Entity Type
Individual
Last Name
Johannssen
First Name
Amanda
Middle Name
L
Credential
CCC-SLP
Mailing Street Address
109 Troup St
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14608-2027
Mailing Country
US
Practice Street Address
109 Troup St
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14608-2027
Practice Country
US
Practice Phone
(315) 717-9191
Enumeration Date
June 03, 2012
Last Updated
June 03, 2012
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)
Other Identifiers
14060744 (NY, American Speech-Language Hearing Association Cerification)