Provider Demographics
NPI:1285513093
Name:GRANT, AMY (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 MAIN RD N
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-1802
Mailing Address - Country:US
Mailing Address - Phone:207-814-0219
Mailing Address - Fax:207-544-5047
Practice Address - Street 1:582 MAIN RD N
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444-1802
Practice Address - Country:US
Practice Address - Phone:207-814-0219
Practice Address - Fax:207-544-5047
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST4446235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist