Provider Demographics
NPI:1518011923
Name:AMATUCCI, ANN M (MOT OTRL)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:AMATUCCI
Suffix:
Gender:F
Credentials:MOT OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:804 SAINT CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2063
Mailing Address - Country:US
Mailing Address - Phone:724-216-2848
Mailing Address - Fax:724-539-0348
Practice Address - Street 1:600 LIGONIER ST
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1426
Practice Address - Country:US
Practice Address - Phone:724-537-5358
Practice Address - Fax:724-537-9826
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005960L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist