Provider Demographics
NPI:1043927163
Name:HA, AMANDA MOY
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MOY
Last Name:HA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:GRACE
Other - Last Name:MOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 ROHLWING RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-1397
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:866-284-6881
Practice Address - Street 1:1911 ROHLWING RD STE A
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-1397
Practice Address - Country:US
Practice Address - Phone:224-248-9449
Practice Address - Fax:866-284-6881
Is Sole Proprietor?:No
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist