Provider Demographics
NPI:1255829537
Name:DENHAM, AMBER MARKETTE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:MARKETTE
Last Name:DENHAM
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 SARATOGA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4965
Mailing Address - Country:US
Mailing Address - Phone:877-991-0009
Mailing Address - Fax:877-207-9553
Practice Address - Street 1:1485 SARATOGA AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4965
Practice Address - Country:US
Practice Address - Phone:877-991-0009
Practice Address - Fax:877-207-9553
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP24341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist