Provider Demographics
NPI:1639970361
Name:ROSEN, AMANDA JILL (MA)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JILL
Last Name:ROSEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:JILL
Other - Last Name:STOECKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:23 CAROL RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1818
Mailing Address - Country:US
Mailing Address - Phone:908-565-4745
Mailing Address - Fax:
Practice Address - Street 1:23 CAROL RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1818
Practice Address - Country:US
Practice Address - Phone:908-565-4745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00531900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist