Provider Demographics
NPI:1992007678
Name:ZAHN, AMY LEE (AUD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:ZAHN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99335
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0335
Mailing Address - Country:US
Mailing Address - Phone:817-735-5418
Mailing Address - Fax:817-735-7780
Practice Address - Street 1:907 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4049
Practice Address - Country:US
Practice Address - Phone:940-565-2262
Practice Address - Fax:940-369-7702
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80341231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX284270001Medicaid