Provider Demographics
NPI:1336514561
Name:ORFANOS, AMANDA MARIE
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:ORFANOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:FREHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCFY-SLP
Mailing Address - Street 1:1453 EUROPEAN DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4022
Mailing Address - Country:US
Mailing Address - Phone:702-558-9900
Mailing Address - Fax:
Practice Address - Street 1:3195 SAINT ROSE PKWY
Practice Address - Street 2:#201
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3501
Practice Address - Country:US
Practice Address - Phone:702-558-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1797235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist