Provider Demographics
NPI:1790949766
Name:BRICK, AMBER LU (MSWL)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LU
Last Name:BRICK
Suffix:
Gender:F
Credentials:MSWL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHERATON DR
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-9316
Mailing Address - Country:US
Mailing Address - Phone:814-949-2050
Mailing Address - Fax:814-949-2051
Practice Address - Street 1:4 SHERATON DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-9316
Practice Address - Country:US
Practice Address - Phone:814-949-2050
Practice Address - Fax:814-949-2051
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker