Provider Demographics
NPI:1740521087
Name:HARTLEY, AMANDA LEE (MS)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LEE
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:9776 QUARTETTE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-3217
Mailing Address - Country:US
Mailing Address - Phone:775-451-7220
Mailing Address - Fax:775-451-7221
Practice Address - Street 1:9776 QUARTETTE DRIVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-3217
Practice Address - Country:US
Practice Address - Phone:775-451-7220
Practice Address - Fax:775-451-7221
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1971 PROVISIONAL235Z00000X
NVSP-1971235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist