Provider Demographics
NPI:1467043638
Name:SAULSBURY, AMBER CHANTELL
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:CHANTELL
Last Name:SAULSBURY
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 1:2703 BOONES LN
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-3449
Mailing Address - Country:US
Mailing Address - Phone:202-569-7091
Mailing Address - Fax:
Practice Address - Street 1:2802 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4980
Practice Address - Country:US
Practice Address - Phone:202-891-1036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant