Provider Demographics
NPI:1154669455
Name:AMENT, SHOSHANA SARA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHOSHANA
Middle Name:SARA
Last Name:AMENT
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 1:12 WILSHER DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2327
Mailing Address - Country:US
Mailing Address - Phone:184-852-5806
Mailing Address - Fax:
Practice Address - Street 1:1696 E 21ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5038
Practice Address - Country:US
Practice Address - Phone:718-360-6873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist