Provider Demographics
NPI:1053650754
Name:WALINGER, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WALINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 GOLDEN EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-8751
Mailing Address - Country:US
Mailing Address - Phone:201-396-5805
Mailing Address - Fax:
Practice Address - Street 1:4578 OAKWOOD LN
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-8670
Practice Address - Country:US
Practice Address - Phone:732-804-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011219235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist