Provider Demographics
NPI:1962836296
Name:HOGE, AMANDA S
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:S
Last Name:HOGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 N HAMPTON
Mailing Address - Street 2:SPECIAL SERVICES- CLAIM CARE
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-1323
Mailing Address - Country:US
Mailing Address - Phone:417-732-3605
Mailing Address - Fax:417-732-3609
Practice Address - Street 1:518 N HAMPTON
Practice Address - Street 2:SPECIAL SERVICES- CLAIM CARE
Practice Address - City:REPUBLIC
Practice Address - State:MO
Practice Address - Zip Code:65738-1323
Practice Address - Country:US
Practice Address - Phone:417-732-3605
Practice Address - Fax:417-732-3609
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist