Provider Demographics
NPI:1417112434
Name:KING, AMY E (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:E
Last Name:KING
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 TIMBERLY LN
Mailing Address - Street 2:
Mailing Address - City:PIPERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18947-1804
Mailing Address - Country:US
Mailing Address - Phone:215-284-8806
Mailing Address - Fax:
Practice Address - Street 1:5614 TIMBERLY LN
Practice Address - Street 2:
Practice Address - City:PIPERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18947-1804
Practice Address - Country:US
Practice Address - Phone:215-284-8806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005792L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist