Provider Demographics
NPI:1245539451
Name:BIRD, AMY MARIE (LICENSED SPEECH-LANG)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:BIRD
Suffix:
Gender:F
Credentials:LICENSED SPEECH-LANG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 ENGLISH ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616
Mailing Address - Country:US
Mailing Address - Phone:585-966-4672
Mailing Address - Fax:585-966-4639
Practice Address - Street 1:2300 ENGLISH RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616
Practice Address - Country:US
Practice Address - Phone:585-966-4672
Practice Address - Fax:585-966-4639
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist