Provider Demographics
NPI:1588126734
Name:MOSSARO, AMANDA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MOSSARO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:MOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2440 E HIGHWAY 290 STE B
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5485
Mailing Address - Country:US
Mailing Address - Phone:512-759-8011
Mailing Address - Fax:512-759-8033
Practice Address - Street 1:2440 E HIGHWAY 290 STE B
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5485
Practice Address - Country:US
Practice Address - Phone:512-759-8011
Practice Address - Fax:512-759-8033
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110088235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist