Detrick, Amy
Detrick, Amy is an sole proprietor health care provider with primary practice located at 421 Kirkwood Dr , Fairborn OH 45324-4429. She recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as her primary health care specialty. Detrick, Amy can be contacted via phone (770) 878-7179.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X |
Profile Details
| NPI number | 1265036982 |
|---|---|
| LBN Legal business name | Detrick, Amy |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 23rd, 2020 |
| Last updated | Nov 23rd, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265036982 | NPPES |
| Ohio | MEDICAID | 0157443 |
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