Provider Demographics
NPI:1932631074
Name:DURINICK, AMY (SLP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DURINICK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MAIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:CT
Mailing Address - Zip Code:06422-2116
Mailing Address - Country:US
Mailing Address - Phone:860-349-8600
Mailing Address - Fax:860-349-8600
Practice Address - Street 1:16 MAIN ST STE 205
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:CT
Practice Address - Zip Code:06422-2116
Practice Address - Country:US
Practice Address - Phone:860-349-8600
Practice Address - Fax:860-349-8600
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist