Provider Demographics
NPI:1043921620
Name:PLEASANTS, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PLEASANTS
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 1:8 WATERS RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2033
Mailing Address - Country:US
Mailing Address - Phone:610-283-0784
Mailing Address - Fax:
Practice Address - Street 1:485 DEVON PARK DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1807
Practice Address - Country:US
Practice Address - Phone:267-405-6375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health