Provider Demographics
NPI:1437623584
Name:COLEMAN, AMBER LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 RIDDLE AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2799
Mailing Address - Country:US
Mailing Address - Phone:304-730-5874
Mailing Address - Fax:
Practice Address - Street 1:100 E PRATT ST STE 2530
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-1074
Practice Address - Country:US
Practice Address - Phone:855-485-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-2444235Z00000X
WV3747P1801X
MD08524235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant