Healthcare Provider Details

I. General information

NPI: 1366351256
Provider Name (Legal Business Name): AMBER ROSE BUTCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SAINT MARKS PL APT 7
NEW YORK NY
10009-5116
US

IV. Provider business mailing address

101 SAINT MARKS PL APT 7
NEW YORK NY
10009-5116
US

V. Phone/Fax

Practice location:
  • Phone: 917-582-7850
  • Fax:
Mailing address:
  • Phone: 917-582-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: