Provider Demographics
NPI:1972755577
Name:PORADO, AMY SUSAN (MOT,OTR/L, CMLDT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUSAN
Last Name:PORADO
Suffix:
Gender:F
Credentials:MOT,OTR/L, CMLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7023 LYONS VEW CT
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-2635
Mailing Address - Country:US
Mailing Address - Phone:724-972-9113
Mailing Address - Fax:
Practice Address - Street 1:7023 LYONS VIEW CT
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-2635
Practice Address - Country:US
Practice Address - Phone:724-972-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004580L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist