Provider Demographics
NPI:1639476419
Name:PAPANOS, AMBER MARIE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARIE
Last Name:PAPANOS
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 1:2051 LULACH LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-7305
Mailing Address - Country:US
Mailing Address - Phone:832-335-0478
Mailing Address - Fax:281-605-5900
Practice Address - Street 1:2051 LULACH LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-7305
Practice Address - Country:US
Practice Address - Phone:832-335-0478
Practice Address - Fax:281-605-5900
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist