Provider Demographics
NPI:1578061537
Name:PEED, AMY JOHNSON (AUDM)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:JOHNSON
Last Name:PEED
Suffix:
Gender:F
Credentials:AUDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 MIDDLESEX DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-7910
Mailing Address - Country:US
Mailing Address - Phone:478-714-3208
Mailing Address - Fax:
Practice Address - Street 1:765 MIDDLESEX DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-7910
Practice Address - Country:US
Practice Address - Phone:478-714-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003492231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist