Provider Demographics
NPI:1154493963
Name:SHENK, AMY (MA SLP CCC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:SHENK
Suffix:
Gender:F
Credentials:MA SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 POST ROAD
Mailing Address - Street 2:J ARTHUR TRUDEAU MEMORIAL CENTER
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7147
Mailing Address - Country:US
Mailing Address - Phone:401-739-2700
Mailing Address - Fax:401-737-8907
Practice Address - Street 1:3445 POST ROAD
Practice Address - Street 2:J ARTHUR TRUDEAU MEMORIAL CENTER
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7147
Practice Address - Country:US
Practice Address - Phone:401-739-2700
Practice Address - Fax:401-737-8907
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI4224OtherNEIGHBORHOOD HEALTH
RI4600113OtherUNITED HEALTHCARE
RI233031OtherBCBS
RIKC02260Medicaid
RI408267OtherBLUE CHIP