Provider Demographics
NPI:1578867792
Name:MYERS BOTT, AMBER CHRISTINE (BA)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:CHRISTINE
Last Name:MYERS BOTT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-1906
Mailing Address - Country:US
Mailing Address - Phone:814-942-9425
Mailing Address - Fax:814-942-9725
Practice Address - Street 1:3010 7TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602
Practice Address - Country:US
Practice Address - Phone:814-942-9425
Practice Address - Fax:814-942-9725
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor