Van Staden, Amanda

Van Staden, Amanda is an individual health care provider with primary practice located at 1230 Johnson Ferry Pl Ste G10 , Marietta GA 30068-2045. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Van Staden, Amanda can be contacted via phone (770) 321-6705.

Contact Information

Primary practice address
1230 Johnson Ferry Pl Ste G10 Marietta GA 30068-2045
Phone: (770) 321-6705
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP009103 Georgia

Profile Details

NPI number 1093173825
LBN Legal business name Van Staden, Amanda
Credentials M.S., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2016
Last updated Sep 8th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093173825 NPPES
Other 14113603 ASHA

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