Provider Demographics
NPI:1962064113
Name:BABCOCK, AMY CHEN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CHEN
Last Name:BABCOCK
Suffix:
Gender:F
Credentials: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:PO BOX 701837
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75370-1837
Mailing Address - Country:US
Mailing Address - Phone:214-483-3170
Mailing Address - Fax:214-377-4244
Practice Address - Street 1:3401 E UNIVERSITY DR STE 301
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-1044
Practice Address - Country:US
Practice Address - Phone:940-384-9999
Practice Address - Fax:214-377-4244
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114992235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist