Provider Demographics
NPI:1740088657
Name:PROCTOR, AMY LYNN (OT/L)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:PROCTOR
Suffix:
Gender:
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BUXTON
Mailing Address - State:ME
Mailing Address - Zip Code:04093-3920
Mailing Address - Country:US
Mailing Address - Phone:207-523-9723
Mailing Address - Fax:
Practice Address - Street 1:726 RIVER RD
Practice Address - Street 2:
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093-3920
Practice Address - Country:US
Practice Address - Phone:207-523-9723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2062225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist