Doctor Name: | AMY WYETH BUCK |
NPI Number: | 1417189606 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 14 Bucks Ln Gardiner, ME - 043456270 |
Business Phone Number: | 2075821278 |
Business Fax Number: | |
Mailing Address: | 14 Bucks Ln, GARDINER |
State: | ME |
Postal Code: | 043456270 |
Phone Number: | 2075821278 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2009 |
NPI Last Update Date: | 08/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385HR2060X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Taxonomy Definition: | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |