Provider Demographics
NPI:1104154566
Name:RAWLINGS, AMY THOMSEN
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:THOMSEN
Last Name:RAWLINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4671 DEL MONTE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 EAST CHASE AVENUE
Practice Address - Street 2:SUITE 107
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-9202
Practice Address - Country:US
Practice Address - Phone:619-334-6548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15468235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist