Provider Demographics
NPI:1013009661
Name:CURTIS, AMY (LADC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5624
Mailing Address - Country:US
Mailing Address - Phone:207-626-3448
Mailing Address - Fax:207-626-3453
Practice Address - Street 1:32 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5624
Practice Address - Country:US
Practice Address - Phone:207-626-3448
Practice Address - Fax:207-626-3453
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC3461101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional