Individual
AMY WITHERITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
560 E 3RD ST, ERIE, PA 16507-1753
(814) 878-4965
Mailing address
5413 W 54TH ST, FAIRVIEW, PA 16415-2367
(814) 397-6110
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC008101
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OC008101
OC008101
PA
Enumeration date
01/10/2017
Last updated
01/10/2017
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