Provider Demographics
NPI:1235381427
Name:STEELE, AMY B
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:STEELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:L B
Other - Last Name:MICKLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 BURMA RD.
Mailing Address - Street 2:P.O. BOX 228
Mailing Address - City:NOBLEBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04555
Mailing Address - Country:US
Mailing Address - Phone:207-691-5693
Mailing Address - Fax:
Practice Address - Street 1:95 DEPOT ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:ME
Practice Address - Zip Code:04862-4211
Practice Address - Country:US
Practice Address - Phone:207-691-5693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00578235Z00000X
MESP2051235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist