Provider Demographics
NPI:1417236456
Name:REID, AMY C (MA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:REID
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 B AUGUSTA ROAD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:ME
Mailing Address - Zip Code:04952-2430
Mailing Address - Country:US
Mailing Address - Phone:207-416-2691
Mailing Address - Fax:
Practice Address - Street 1:91 CAMDEN ST
Practice Address - Street 2:SUITE 108
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2430
Practice Address - Country:US
Practice Address - Phone:207-975-2453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP2170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist