Individual ProviderAmanda DistefanoSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address13336 Industrial Rd, Suite 105, Omaha, NE 68137-1124(402) 330-3211(402) 715-2955PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Distefano 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 2 days ago.Profile DetailsProvider ID1710322532Provider TypeIndividualFull NameDistefano, AmandaCredentialSLPGenderFemaleSole ProprietorNoEnumeration Date5/7/2013Last Updated11/20/2024Contact InformationPractice LocationPractice Address13336 Industrial Rd, Suite 105, Omaha, NE 68137-1124Phone(402) 330-3211Fax(402) 330-5970Mailing LocationMailing Address5717 S 112th St, Omaha, NE 68137-3652Phone(402) 715-2955Fax(402) 330-5970Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense1670Nebraska