Provider Demographics
NPI:1083329007
Name:REESE, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:REESE
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 1:209 GADSBY RD
Mailing Address - Street 2:
Mailing Address - City:STONEBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16153-4105
Mailing Address - Country:US
Mailing Address - Phone:724-372-3108
Mailing Address - Fax:
Practice Address - Street 1:353 N DUFFY RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1138
Practice Address - Country:US
Practice Address - Phone:800-362-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139705104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker