Provider Demographics
NPI:1891820403
Name:TOWNSEND, AMY E (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:E
Last Name:TOWNSEND
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 1:13000 W BETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47396-9747
Mailing Address - Country:US
Mailing Address - Phone:765-744-5306
Mailing Address - Fax:765-759-9403
Practice Address - Street 1:13000 W BETHEL AVE
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:IN
Practice Address - Zip Code:47396-9747
Practice Address - Country:US
Practice Address - Phone:765-744-5306
Practice Address - Fax:765-759-9403
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002870A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist