Most Relevant Information
Provider Data
| NPI Number: | 1003417015 |
| Provider Name: | AMANDA MCCORMICK M.S., CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 8161 |
Most Important Dates
| Enumeration Date: | 11/05/2020 |
| Last Updated: | 11/05/2020 |
Provider Practice Location
1201 DEREK DR STE 1
HAMMOND
LA
704035755
Practice Location Phone/Fax
| Phone: | 9854021145 |
| Fax: |
Provider Mailing Location
1201 DEREK DR STE 1
HAMMOND
LA
704035755
Provider Mailing Phone/Fax
| Phone: | 9854021145 |
| Fax: |