Provider Demographics
NPI:1649699133
Name:BELLAMY, AMANDA SANGES (MA, SLP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:SANGES
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5032 LONGMONT CT
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7789
Mailing Address - Country:US
Mailing Address - Phone:704-985-2799
Mailing Address - Fax:
Practice Address - Street 1:3201 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1455
Practice Address - Country:US
Practice Address - Phone:336-541-8167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist