Provider Demographics
NPI:1700927936
Name:YORK, AMY R (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:YORK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 LILY XING
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-5205
Mailing Address - Country:US
Mailing Address - Phone:919-359-0074
Mailing Address - Fax:919-359-0049
Practice Address - Street 1:126 LILY XING
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-5205
Practice Address - Country:US
Practice Address - Phone:919-359-0074
Practice Address - Fax:919-359-0049
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist