Provider Demographics
NPI:1306076658
Name:CARR, AMY LYNETTE
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNETTE
Last Name:CARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 RINEYVILLE BIG SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:RINEYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40162-9617
Mailing Address - Country:US
Mailing Address - Phone:270-360-9310
Mailing Address - Fax:
Practice Address - Street 1:3350 RINEYVILLE BIG SPRINGS RD
Practice Address - Street 2:
Practice Address - City:RINEYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40162-9617
Practice Address - Country:US
Practice Address - Phone:270-360-9310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist