Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Amanda Lynn Jacob, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1912480526

Amanda Lynn Jacob, CCC-SLP is a Speech-Language Pathologist in Sunrise, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2018
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

14201 W Sunrise Blvd Ste 107
Sunrise, FL 33323-3207
Phone: (954) 756-2818
Fax: (954) 514-1126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SA17265 (FL)

Record details

NPI number1912480526
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorYes
NPI enumeratedSeptember 10, 2018
Last updated in NPPESAugust 11, 2020
Certification dateAugust 11, 2020

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