Provider Demographics
NPI:1215452875
Name:DUMPERTH, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DUMPERTH
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 1:302 WOODLAND WAY
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:OH
Mailing Address - Zip Code:44047-8323
Mailing Address - Country:US
Mailing Address - Phone:1440-228-0792
Mailing Address - Fax:
Practice Address - Street 1:12496 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:HUNTSBURG
Practice Address - State:OH
Practice Address - Zip Code:44046-9792
Practice Address - Country:US
Practice Address - Phone:440-635-5567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2017395-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist