Provider Demographics
NPI:1932474590
Name:GRAY-BAUM, AMANDA F
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:F
Last Name:GRAY-BAUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 GLENWILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-3300
Mailing Address - Country:US
Mailing Address - Phone:502-263-3503
Mailing Address - Fax:
Practice Address - Street 1:3805 GLENWILLOW WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-3300
Practice Address - Country:US
Practice Address - Phone:502-263-3503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter