Provider Demographics
NPI:1629280227
Name:LESTER, AMANDA DAMARIS (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:DAMARIS
Last Name:LESTER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:DAMARIS
Other - Last Name:LESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1269 KRAMERIA STREET
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:720-261-3972
Mailing Address - Fax:
Practice Address - Street 1:1780 S BELLAIRE ST
Practice Address - Street 2:SUITE 515
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4307
Practice Address - Country:US
Practice Address - Phone:303-759-5316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12030509235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist