Provider Demographics
NPI:1063466092
Name:PARKER, AMANDA MARIE (AUD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5408 SANDERLING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3996
Mailing Address - Country:US
Mailing Address - Phone:813-326-4804
Mailing Address - Fax:
Practice Address - Street 1:5408 SANDERLING RIDGE DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-3996
Practice Address - Country:US
Practice Address - Phone:813-326-4804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1311231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist