Provider Demographics
NPI:1306680038
Name:KIRBY, AMELIA CLAIRE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:CLAIRE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22391 FLORA PARKE XING UNIT A
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-8005
Mailing Address - Country:US
Mailing Address - Phone:904-321-9054
Mailing Address - Fax:855-565-1769
Practice Address - Street 1:22391 FLORA PARKE XING UNIT A
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-8005
Practice Address - Country:US
Practice Address - Phone:904-321-9054
Practice Address - Fax:855-565-1769
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11936235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist