Individual ProviderAmanda LangeSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1611 Headway Cir, Austin, TX 78754-5160(512) 615-7123(979) 885-9785PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Lange does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1639307929Provider TypeIndividualFull NameLange, AmandaCredentialSLPGenderFemaleSole ProprietorYesEnumeration Date6/25/2009Last Updated6/25/2009Contact InformationPractice LocationPractice Address1611 Headway Cir, Austin, TX 78754-5160Phone(512) 615-7123FaxUnlisted FaxMailing LocationMailing Address816 Sheraton Ave, Austin, TX 78745-2044Phone(979) 885-9785FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense104483Texas