Most Relevant Information
Provider Data
| NPI Number: | 1003646670 |
| Provider Name: | AMANDA ERICSON |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 242007595 |
Most Important Dates
| Enumeration Date: | 08/07/2024 |
| Last Updated: | 08/07/2024 |
Provider Practice Location
5837 QUEENS CV
LISLE
IL
605323164
Practice Location Phone/Fax
| Phone: | 6305447289 |
| Fax: |
Provider Mailing Location
5837 QUEENS CV
LISLE
IL
605323164
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |