Provider Demographics
NPI:1508320482
Name:STARR, AMBER NICOLE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:STARR
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:PERRYOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15473-1253
Mailing Address - Country:US
Mailing Address - Phone:724-322-5692
Mailing Address - Fax:
Practice Address - Street 1:900 PORTER AVE
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683-1147
Practice Address - Country:US
Practice Address - Phone:724-887-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015896225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist