Provider Demographics
NPI:1942329917
Name:KAHN, AMY LYNN (MA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:KAHN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N DIANTHUS ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5939
Mailing Address - Country:US
Mailing Address - Phone:310-379-4110
Mailing Address - Fax:
Practice Address - Street 1:707 N DIANTHUS ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5939
Practice Address - Country:US
Practice Address - Phone:310-379-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASLP3666235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist