Provider Demographics
NPI:1336408061
Name:HEANEY, AMANDA LISA
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LISA
Last Name:HEANEY
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 1:7410 BOYNTON BEACH BLVD STE B1
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6157
Mailing Address - Country:US
Mailing Address - Phone:561-223-1650
Mailing Address - Fax:561-484-5091
Practice Address - Street 1:7410 BOYNTON BEACH BLVD STE B1
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6157
Practice Address - Country:US
Practice Address - Phone:561-223-1650
Practice Address - Fax:561-484-5091
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist