Provider Demographics
NPI:1508346339
Name:CIFUENTES, AMANDA KAYE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAYE
Last Name:CIFUENTES
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 1:3015 COOPER BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2959
Mailing Address - Country:US
Mailing Address - Phone:513-435-1439
Mailing Address - Fax:
Practice Address - Street 1:494 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1470
Practice Address - Country:US
Practice Address - Phone:740-369-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist