Most Relevant Information
Provider Data
| NPI Number: | 1003013590 |
| Provider Name: | AMANDA RUTH LANE M.S. CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 3125 |
Most Important Dates
| Enumeration Date: | 06/28/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
867 MCGUIRE AVE
PADUCAH
KY
420014036
Practice Location Phone/Fax
| Phone: | 2704426168 |
| Fax: | 2704436211 |
Provider Mailing Location
1186 HALE SPRINGS RD
BENTON
KY
420254713
Provider Mailing Phone/Fax
| Phone: | 2702520203 |
| Fax: |