Provider Demographics
NPI:1225174642
Name:PFINGSTEN, AMY Y
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:Y
Last Name:PFINGSTEN
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 1:215 EUGENIA
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:IL
Mailing Address - Zip Code:62285
Mailing Address - Country:US
Mailing Address - Phone:618-550-8213
Mailing Address - Fax:618-222-1520
Practice Address - Street 1:215 EUGENIA
Practice Address - Street 2:
Practice Address - City:SMITHTON
Practice Address - State:IL
Practice Address - Zip Code:62285
Practice Address - Country:US
Practice Address - Phone:618-550-8213
Practice Address - Fax:618-222-1520
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist