Individual
AMY HAYCISAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1513 FAIRLANE RD, SUMMERHILL, PA 15958-5007
(814) 241-4829
Mailing address
1513 FAIRLANE RD, SUMMERHILL, PA 15958-5007
(814) 241-4829
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC010150
PA
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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