Provider Demographics
NPI:1114365111
Name:SCHMITZ, AMANDA JEAN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JEAN
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74B CENTENNIAL LOOP STE 100
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7919
Mailing Address - Country:US
Mailing Address - Phone:541-346-1640
Mailing Address - Fax:
Practice Address - Street 1:74B CENTENNIAL LOOP STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7919
Practice Address - Country:US
Practice Address - Phone:541-346-1640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR016552235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist