Provider Demographics
NPI:1336811355
Name:MAJOR, AMANDA BEVERLY (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:BEVERLY
Last Name:MAJOR
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 PUTNAM RD APT 8
Mailing Address - Street 2:
Mailing Address - City:FOXBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2128
Mailing Address - Country:US
Mailing Address - Phone:413-886-9607
Mailing Address - Fax:
Practice Address - Street 1:33 PUTNAM RD APT 8
Practice Address - Street 2:
Practice Address - City:FOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:02035-2128
Practice Address - Country:US
Practice Address - Phone:413-886-9607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist