Provider Demographics
NPI:1629089487
Name:DEAN, AMIE MANGINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:MANGINE
Last Name:DEAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:AMIE
Other - Middle Name:REBECCA
Other - Last Name:MANGINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1426 B S HOUSTON STREET
Mailing Address - Street 2:
Mailing Address - City:BULLARD
Mailing Address - State:TX
Mailing Address - Zip Code:75757
Mailing Address - Country:US
Mailing Address - Phone:903-894-2930
Mailing Address - Fax:281-494-0655
Practice Address - Street 1:2008 PANTHER CROSSING
Practice Address - Street 2:
Practice Address - City:BULLARD
Practice Address - State:TX
Practice Address - Zip Code:75757
Practice Address - Country:US
Practice Address - Phone:903-894-2930
Practice Address - Fax:281-494-0655
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100357235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist