Basic Information
| Provider Information | |||||||||
| NPI: | 1053615369 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOLOVICH | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | AMBER WOLOVICH | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | WOLOVICH | ||||||||
| OtherFirstName: | AMBER | ||||||||
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| OtherCredential: | AMBER WOLOVICH, OTR | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 116 COUNTRY CLUB DR | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152354112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122410417 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9850 OLD PERRY HWY | ||||||||
| Address2: | |||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150909311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123667900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2010 | ||||||||
| LastUpdateDate: | 12/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC006728L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.