MEDICARE: AMBER WHITNEY SEVERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	BH003971	PA

General Provider Information

NPI Number	:	1700442365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER WHITNEY SEVERA

Provider Business Mailing Address
First Line	:	1428 MOORE ST
Second Line	:
City	:	HUNTINGDON
State	:	PA
Zip	:	16652-2024
Country	:	US
Telephone Number	:	814-312-3973
Fax Number	:

Provider Business Practice Location Address
First Line	:	1428 MOORE ST
Second Line	:
City	:	HUNTINGDON
State	:	PA
Zip	:	16652-2024
Country	:	US
Telephone Number	:	814-312-3973
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2019
Last Update Date	:	05/19/2019

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Directions to “ AMBER WHITNEY SEVERA ” Practice Location

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