Provider Demographics
NPI:1477810356
Name:PAEZ, AMANDA MELISSA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:MELISSA
Last Name:PAEZ
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 1:3333 HENRY HUDSON PKWY APT 20E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3227
Mailing Address - Country:US
Mailing Address - Phone:917-647-1004
Mailing Address - Fax:
Practice Address - Street 1:3333 HENRY HUDSON PKWY APT 20E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3227
Practice Address - Country:US
Practice Address - Phone:917-647-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program