Individual
AMBER FAITH BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1104 WELSH RD, PHILADELPHIA, PA 19115
(215) 676-9191
Mailing address
1104 WELSH RD, PHILA, PA 19115-3730
(215) 676-9191
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP009660
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7770004344678901
—
NJ
Enumeration date
04/28/2021
Last updated
04/28/2021
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