Provider Demographics
NPI:1972914802
Name:WEAVER, AMY BETH (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:WEAVER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:503 PEAK VIEW RD
Mailing Address - Street 2:
Mailing Address - City:YORK SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17372-9782
Mailing Address - Country:US
Mailing Address - Phone:717-321-6189
Mailing Address - Fax:
Practice Address - Street 1:1000 CLAREMONT RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-7310
Practice Address - Country:US
Practice Address - Phone:717-240-1953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006570224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant