Provider Demographics
NPI:1770608309
Name:HOWARD, AMI JO (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:JO
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9842 E 1610 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:61858-6106
Mailing Address - Country:US
Mailing Address - Phone:217-260-9664
Mailing Address - Fax:
Practice Address - Street 1:9842 E 1610 NORTH RD
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:IL
Practice Address - Zip Code:61858-6106
Practice Address - Country:US
Practice Address - Phone:217-260-9664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146005285235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist