Provider Demographics
NPI:1467119974
Name:PAULEY, AMANDA M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:PAULEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 MCLAUGHLIN RUN RD STE 216
Mailing Address - Street 2:
Mailing Address - City:UPPER ST CLAIR
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3100
Mailing Address - Country:US
Mailing Address - Phone:412-407-3539
Mailing Address - Fax:
Practice Address - Street 1:1580 MCLAUGHLIN RUN RD STE 216
Practice Address - Street 2:
Practice Address - City:UPPER ST CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-3100
Practice Address - Country:US
Practice Address - Phone:412-407-3539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL015242235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist