Provider Demographics
NPI:1720726789
Name:BENNETT, AMANDA FAYE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:FAYE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 E OLD SETTLERS BLVD APT 1036
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-2652
Mailing Address - Country:US
Mailing Address - Phone:361-815-8055
Mailing Address - Fax:
Practice Address - Street 1:810 E 13TH AVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-2298
Practice Address - Country:US
Practice Address - Phone:254-939-1876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist