Provider Demographics
NPI:1801034046
Name:EDWARDS, AMY LYNNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNNE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNNE
Other - Last Name:JARMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:4126 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4123
Practice Address - Country:US
Practice Address - Phone:812-645-2308
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004861A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist