Provider Demographics
NPI:1982038469
Name:SHUE, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SHUE
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 1:80 PROFESSIONAL CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5152
Mailing Address - Country:US
Mailing Address - Phone:765-448-1758
Mailing Address - Fax:765-448-3898
Practice Address - Street 1:80 PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5152
Practice Address - Country:US
Practice Address - Phone:765-448-1758
Practice Address - Fax:765-448-3898
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005757A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist