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General NPI Number Information
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NPI Number | 1083202329
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Entity Type | Individual
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Provider Name | AMY REPKO
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Gender | Female
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 3025 JACKS RUN RD
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City | WHITE OAK
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State | PA
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Zip | 15131-2549
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Country | US
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Telephone | 724-612-2791
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Fax |
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Provider Business Mailing Address
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Address Line | 16055 PERRY HWY
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City | WEXFORD
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State | PA
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Zip | 15090-6885
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Country | US
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Telephone | 412-566-9697
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | BH001204
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | AP001131
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License Number State | PA
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