Amy Detrick

NPI #1265036982 in Fairborn, Ohio

Provider Information

NPI Number: 1265036982
Entity Type: Individual
Name: Amy Detrick
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Clinic/Center - Developmental Disabilities
Enumeration Date: Nov 23, 2020
Last Updated: Nov 23, 2020

Practice Location

Address: 421 KIRKWOOD DR
City: Fairborn
State: Ohio
ZIP Code: 45324-4429
Phone: (770) 878-7179

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Developmental Disabilities — Developmental Disabilities	261QD1600X	Primary

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