Provider Demographics
NPI:1780014043
Name:SANOR, AMANDA (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SANOR
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8963 KETTERING RD
Mailing Address - Street 2:
Mailing Address - City:EAST ROCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:44625-9716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 CAROLYN CT
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-8703
Practice Address - Country:US
Practice Address - Phone:330-868-4104
Practice Address - Fax:330-868-7714
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7881235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist