Provider Demographics
NPI:1922297381
Name:BENE, AMANDA HOFFMAN (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:HOFFMAN
Last Name:BENE
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 1:643 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2005
Mailing Address - Country:US
Mailing Address - Phone:985-652-2734
Mailing Address - Fax:
Practice Address - Street 1:643 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-2005
Practice Address - Country:US
Practice Address - Phone:985-652-2734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4941235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist