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General NPI Number Information
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NPI Number | 1194489377
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Entity Type | Individual
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Provider Name | AMBER CLUKEY
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Gender | Female
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 587 N DEER ISLE RD
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City | DEER ISLE
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State | ME
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Zip | 04627-3438
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Country | US
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Telephone | 855-390-7774
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Fax | 855-734-4666
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Provider Business Mailing Address
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Address Line | 1 STILES RD STE 203
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City | SALEM
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State | NH
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Zip | 03079-4804
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Country | US
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Telephone | 855-390-7774
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Fax | 855-734-4666
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | TO4188
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License Number State | ME
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