Provider Demographics
NPI:1588861017
Name:SPEARS, AMBER N (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:N
Last Name:SPEARS
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 1:781 PENNY LN
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:IN
Mailing Address - Zip Code:46167-8997
Mailing Address - Country:US
Mailing Address - Phone:317-430-1303
Mailing Address - Fax:
Practice Address - Street 1:781 PENNY LN
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:IN
Practice Address - Zip Code:46167-8997
Practice Address - Country:US
Practice Address - Phone:317-430-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004281A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist