Provider Demographics
NPI:1396095949
Name:PINTO, AMANDA MCQUEEN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MCQUEEN
Last Name:PINTO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:7264 GRIMMS LNDG
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-9036
Mailing Address - Country:US
Mailing Address - Phone:850-281-2779
Mailing Address - Fax:
Practice Address - Street 1:7552 NAVARRE PKWY UNIT 32
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7308
Practice Address - Country:US
Practice Address - Phone:850-939-3944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLSA12770235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist