Provider Demographics
NPI:1154021319
Name:HOOTEN, AMANDA (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:HOOTEN
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 1:13749 LEIGH DR
Mailing Address - Street 2:
Mailing Address - City:BONNER SPRINGS
Mailing Address - State:KS
Mailing Address - Zip Code:66012-1742
Mailing Address - Country:US
Mailing Address - Phone:816-273-9599
Mailing Address - Fax:
Practice Address - Street 1:2001 NW 87TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1334
Practice Address - Country:US
Practice Address - Phone:816-436-9623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016030818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist