Provider Demographics
NPI:1508925629
Name:BOOTH, AMY ENGLER (MA CCCA FAAA)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:ENGLER
Last Name:BOOTH
Suffix:
Gender:F
Credentials:MA CCCA FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 DUNN HALL
Mailing Address - Street 2:ROOM 336 UNIVERSITY OF MAINE
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04469-5724
Mailing Address - Country:US
Mailing Address - Phone:207-581-2011
Mailing Address - Fax:207-581-2060
Practice Address - Street 1:5724 DUNN HALL
Practice Address - Street 2:ROOM 336 UNIVERSITY OF MAINE
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04469-5724
Practice Address - Country:US
Practice Address - Phone:207-581-2011
Practice Address - Fax:207-581-2060
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP940231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME028000OtherANTHEM BCBS