Provider Demographics
NPI:1437637212
Name:PENFOLD, AMBER NICOLE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:NICOLE
Last Name:PENFOLD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NICOLE
Other - Last Name:FERREIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:387 QUARRY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1026
Mailing Address - Country:US
Mailing Address - Phone:508-324-9300
Mailing Address - Fax:
Practice Address - Street 1:387 QUARRY ST STE 102
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1026
Practice Address - Country:US
Practice Address - Phone:508-324-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23838225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist