Provider Demographics
NPI:1457039315
Name:PRATT, AMANDA MILLER (AUD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MILLER
Last Name:PRATT
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 1:4374 S MAIN ST UNIT 410
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3371
Mailing Address - Country:US
Mailing Address - Phone:385-297-1045
Mailing Address - Fax:
Practice Address - Street 1:756 E 12200 S
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9724
Practice Address - Country:US
Practice Address - Phone:801-804-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13460528-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist