Provider Demographics
NPI: | 1265808091 |
---|---|
Name: | DIDONNE, AMY |
Entity type: | Individual |
Prefix: | MRS |
First Name: | AMY |
Middle Name: | |
Last Name: | DIDONNE |
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: | 6044 S ORANGE AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | ORLANDO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32809-4283 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-855-9799 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6044 S ORANGE AVE |
Practice Address - Street 2: | |
Practice Address - City: | ORLANDO |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32809-4283 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-855-9799 |
Practice Address - Fax: | 321-245-0465 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2015-08-17 |
Last Update Date: | 2024-03-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | 23-261097 | 106S00000X |
FL | S15993 | 2355S0801X |
FL | AST446 | 237700000X |
FL | AS5150 | 237700000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 237700000X | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | |
No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |