Provider Demographics
NPI:1255841805
Name:PILLION, AMANDA L (MED, CCC-A)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:PILLION
Suffix:
Gender:F
Credentials:MED, CCC-A
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37605
Mailing Address - Country:US
Mailing Address - Phone:423-928-6464
Mailing Address - Fax:423-232-7970
Practice Address - Street 1:225 MIDWAY MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:37620
Practice Address - Country:US
Practice Address - Phone:423-797-4555
Practice Address - Fax:423-797-4556
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001087231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist