Provider Demographics
NPI:1316380413
Name:LESTER, AMY (ITFS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:LESTER
Suffix:
Gender:F
Credentials:ITFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 HAMLIN FORD RD
Mailing Address - Street 2:
Mailing Address - City:STONEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27048-8612
Mailing Address - Country:US
Mailing Address - Phone:336-268-5350
Mailing Address - Fax:
Practice Address - Street 1:191 HAMLIN FORD RD
Practice Address - Street 2:
Practice Address - City:STONEVILLE
Practice Address - State:NC
Practice Address - Zip Code:27048-8612
Practice Address - Country:US
Practice Address - Phone:336-268-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator