Provider Demographics
NPI:1720396278
Name:HOUSE, AMY PAULA (MA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:PAULA
Last Name:HOUSE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E 95TH ST
Mailing Address - Street 2:#2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-4012
Mailing Address - Country:US
Mailing Address - Phone:917-306-5343
Mailing Address - Fax:
Practice Address - Street 1:235 E 95TH ST
Practice Address - Street 2:APT 2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-4012
Practice Address - Country:US
Practice Address - Phone:917-306-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020015235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist