Provider Demographics
NPI:1316434491
Name:UPTON, AMY S (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:S
Last Name:UPTON
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 1:4828 TULANE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4761
Mailing Address - Country:US
Mailing Address - Phone:318-277-1811
Mailing Address - Fax:
Practice Address - Street 1:8120 KELWOOD AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4843
Practice Address - Country:US
Practice Address - Phone:318-277-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-15
Last Update Date:2018-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist