Provider Demographics
NPI:1376802421
Name:SAPARTO, AMY V (CSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:V
Last Name:SAPARTO
Suffix:
Gender:F
Credentials:CSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5883
Mailing Address - Country:US
Mailing Address - Phone:541-301-1288
Mailing Address - Fax:
Practice Address - Street 1:2105 LAKEWAY DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5883
Practice Address - Country:US
Practice Address - Phone:541-301-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12244235Z00000X
TX108914235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist