Provider Demographics
NPI:1821434903
Name:CHAPMAN, AMY LAUREN (MA SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LAUREN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 N MOUNTAIN VIEW PL
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-1225
Mailing Address - Country:US
Mailing Address - Phone:714-642-7126
Mailing Address - Fax:
Practice Address - Street 1:1627 N MOUNTAIN VIEW PL
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-1225
Practice Address - Country:US
Practice Address - Phone:714-642-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist