Provider Demographics
NPI:1245489442
Name:TRAUBERT, AMY CLAIRE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CLAIRE
Last Name:TRAUBERT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:CLAIRE
Other - Last Name:LANGSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1200 N FREDERICK PIKE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603-8600
Mailing Address - Country:US
Mailing Address - Phone:540-831-0617
Mailing Address - Fax:
Practice Address - Street 1:1200 N FREDERICK PIKE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-8600
Practice Address - Country:US
Practice Address - Phone:540-831-0617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1245489442Medicaid
WV3810013051Medicaid