Provider Demographics
NPI:1801278817
Name:LOUGHER, AMY (MS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:LOUGHER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 E GOLDFINCH GATE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4510
Mailing Address - Country:US
Mailing Address - Phone:480-329-7929
Mailing Address - Fax:
Practice Address - Street 1:4542 E INVERNESS AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4619
Practice Address - Country:US
Practice Address - Phone:480-926-6309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP9481235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist