Provider Demographics
NPI:1790026839
Name:KEY, AMY KRISTEEN (SLP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:KRISTEEN
Last Name:KEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:K
Other - Last Name:MIRDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 EXETER RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3966
Practice Address - Country:US
Practice Address - Phone:901-757-1350
Practice Address - Fax:901-757-3496
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist