Provider Demographics
NPI:1467779264
Name:WOOD, AMANDA BETH (EDD, SLPA)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:BETH
Last Name:WOOD
Suffix:
Gender:F
Credentials:EDD, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18929 E CHERRY HILLS PL
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-3197
Mailing Address - Country:US
Mailing Address - Phone:480-580-8207
Mailing Address - Fax:
Practice Address - Street 1:18929 E CHERRY HILLS PL
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-3197
Practice Address - Country:US
Practice Address - Phone:480-580-8207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA142972355S0801X
AZSLPL4487235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist