Provider Demographics
NPI:1770269813
Name:ROSE-SMITH, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ROSE-SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WESTMORELAND CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15692-1143
Mailing Address - Country:US
Mailing Address - Phone:412-773-2969
Mailing Address - Fax:
Practice Address - Street 1:4154 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1942
Practice Address - Country:US
Practice Address - Phone:412-295-4345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015465101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health