Provider Demographics
NPI:1134310469
Name:SHOPE, AMY SUE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUE
Last Name:SHOPE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 BRADY AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1259
Mailing Address - Country:US
Mailing Address - Phone:724-846-8255
Mailing Address - Fax:724-846-8255
Practice Address - Street 1:151 BRADY AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1259
Practice Address - Country:US
Practice Address - Phone:724-846-8255
Practice Address - Fax:724-846-8255
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006109L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist