Provider Demographics
NPI:1619697802
Name:DELL'AIRA, AMANDA DEFRANCE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:DEFRANCE
Last Name:DELL'AIRA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 COLLEGE
Mailing Address - Street 2:
Mailing Address - City:ITALY
Mailing Address - State:TX
Mailing Address - Zip Code:76651-3935
Mailing Address - Country:US
Mailing Address - Phone:432-413-6880
Mailing Address - Fax:
Practice Address - Street 1:303 W KNOX ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-3966
Practice Address - Country:US
Practice Address - Phone:972-872-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118793235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist