Provider Demographics
NPI:1598993081
Name:SIMPSON, AMANDA KAYE (MA SLP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KAYE
Last Name:SIMPSON
Suffix:
Gender:
Credentials:MA SLP
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:KAYE
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA SLP
Mailing Address - Street 1:701 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:MENDOTA
Mailing Address - State:IL
Mailing Address - Zip Code:61342
Mailing Address - Country:US
Mailing Address - Phone:815-674-9294
Mailing Address - Fax:815-672-1686
Practice Address - Street 1:701 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364-2436
Practice Address - Country:US
Practice Address - Phone:815-672-1686
Practice Address - Fax:815-672-1686
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006517235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist