Provider Demographics
NPI:1700587805
Name:CASILE, AMANDA MAUREEN (MSC, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MAUREEN
Last Name:CASILE
Suffix:
Gender:F
Credentials:MSC, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-2116
Mailing Address - Country:US
Mailing Address - Phone:908-499-8773
Mailing Address - Fax:
Practice Address - Street 1:25 LINDSLEY DR
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4455
Practice Address - Country:US
Practice Address - Phone:908-499-8773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01180800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist