Provider Demographics
NPI:1316574445
Name:ROWLAND, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:GANSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:363 BELLVER
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-7612
Mailing Address - Country:US
Mailing Address - Phone:562-385-7063
Mailing Address - Fax:
Practice Address - Street 1:25381 COMMERCENTRE DR STE 100
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-8860
Practice Address - Country:US
Practice Address - Phone:714-824-9610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29660235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist