Provider Demographics
NPI:1467636035
Name:CLOWER, AMY MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:CLOWER
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:HC 66 BOX 32E
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-9403
Mailing Address - Country:US
Mailing Address - Phone:304-822-3468
Mailing Address - Fax:
Practice Address - Street 1:111 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-1522
Practice Address - Country:US
Practice Address - Phone:304-822-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-0976235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist