Provider Demographics
NPI:1083012660
Name:DELL, AMARA
Entity Type:Individual
Prefix:
First Name:AMARA
Middle Name:
Last Name:DELL
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 1:303 VETERANS DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW BLOOMFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:17068
Mailing Address - Country:US
Mailing Address - Phone:717-582-4325
Mailing Address - Fax:
Practice Address - Street 1:303 VETERANS DRIVE
Practice Address - Street 2:
Practice Address - City:NEW BLOOMFIELD
Practice Address - State:PA
Practice Address - Zip Code:17068
Practice Address - Country:US
Practice Address - Phone:717-582-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC013614252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency