| Amy Shandy, Speech-language Pathologist, Llc | |
|
901 N Santa Fe Ave Fountain CO 80817-1738 | |
| (719) 597-0822 | |
| (719) 597-0822 |
| Full Name | Amy Shandy, Speech-language Pathologist, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 901 N Santa Fe Ave, Fountain, Colorado |
| Authorized Official Name and Position | Rebecca Newman (BILLING MANAGER) |
| Authorized Official Contact | 7195970822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Shandy, Speech-language Pathologist, Llc 685 Citadel Dr E Ste 580 Colorado Springs CO 80909-5381 Ph: () - | Amy Shandy, Speech-language Pathologist, Llc 901 N Santa Fe Ave Fountain CO 80817-1738 Ph: (719) 597-0822 |
| NPI Number | 1154936466 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 09/14/2020 |
| Certification Date | 09/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154936466 | NPI | - | NPPES |
| 12000256 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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Amy Shandy, Speech-language Pathologist, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 N Santa Fe Ave, Fountain, CO 80817 Phone: 719-597-0822 Fax: 715-599-4606 |