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Amy Detrick
Developmental Disabilities Clinic/Center in Fairborn, Ohio
NPI 1265036982

Amy Detrick is a Developmental Disabilities Clinic/Center based in Fairborn, OH and is specialized in Developmental Disabilities. Amy Detrick practices in Fairborn, OH. The NPI Number for Amy Detrick is 1265036982 and holds a License No. (Ohio).

The current practice location address for Amy Detrick is 421 Kirkwood Dr, Fairborn, OH and can be reached out via phone at 770-878-7179. You can also correspond with Amy Detrick through the mailing address at 421 KIRKWOOD DR, FAIRBORN, OH - 45324-4429 (mailing address contact number: 770-878-7179).

Location: 421 Kirkwood Dr, Fairborn, OH, 45324-4429
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265036982
Provider Name
Amy Detrick
Credential
Provider Entity Type
Individual
Gender
Female
Address
421 Kirkwood Dr, Fairborn, OH, 45324-4429
Phone Number
770-878-7179
Fax Number
Provider Enumeration Date
11/23/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0157443 05 OH
institution
Provider Business Practice Location Address Details
Address
421 Kirkwood Dr
City
Fairborn
State
Ohio
Zip
45324-4429
Phone Number
770-878-7179
Fax Number
person
Provider Business Mailing Address Details
Address
421 Kirkwood Dr
City
Fairborn
State
Ohio
Zip
45324-4429
Phone Number
770-878-7179
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
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