Provider Demographics
NPI:1528370178
Name:MCHENRY, AMANDA MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE
Last Name:MCHENRY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:SCHENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:PO BOX 406153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1876
Mailing Address - Country:US
Mailing Address - Phone:561-478-8770
Mailing Address - Fax:561-688-8877
Practice Address - Street 1:409 NORTH STATE STREET
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1097
Practice Address - Country:US
Practice Address - Phone:570-586-5121
Practice Address - Fax:570-586-5124
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006169231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist