Provider Demographics
NPI:1043403959
Name:UEBELHOER, AMY JOAN (MSCCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:JOAN
Last Name:UEBELHOER
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:DURAND
Mailing Address - State:IL
Mailing Address - Zip Code:61024-9590
Mailing Address - Country:US
Mailing Address - Phone:815-248-2151
Mailing Address - Fax:815-248-2771
Practice Address - Street 1:402 CENTER ST
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:IL
Practice Address - Zip Code:61024-9590
Practice Address - Country:US
Practice Address - Phone:815-248-2151
Practice Address - Fax:815-248-2771
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146005378235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist