Provider Demographics
NPI:1639457112
Name:WILLIAMS, AMANDA MARIE (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:VANDEN HOEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPEECH LANGUAGE PATH
Mailing Address - Street 1:3175 SIENNA DR S STE 103
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8910
Mailing Address - Country:US
Mailing Address - Phone:701-532-1906
Mailing Address - Fax:701-532-1896
Practice Address - Street 1:3175 SIENNA DR S STE 103
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8910
Practice Address - Country:US
Practice Address - Phone:701-532-1906
Practice Address - Fax:701-532-1896
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1175235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist