Provider Demographics
NPI:1205263910
Name:FOLEY, AMY J (MED, BCBA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:J
Last Name:FOLEY
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:J
Other - Last Name:KLINCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA
Mailing Address - Street 1:48 SENTRY WAY
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-4407
Mailing Address - Country:US
Mailing Address - Phone:978-697-1167
Mailing Address - Fax:
Practice Address - Street 1:48 SENTRY WAY
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4407
Practice Address - Country:US
Practice Address - Phone:978-697-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-5022103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst