MEDICARE: AMBER READEL

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	225X00000X	Occupational Therapist	6889	AZ

General Provider Information

NPI Number	:	1366960486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER READEL

Provider Business Mailing Address
First Line	:	9273 W RUNION DR
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-5213
Country	:	US
Telephone Number	:	847-452-3474
Fax Number	:

Provider Business Practice Location Address
First Line	:	9150 W INDIAN SCHOOL RD STE 105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-2385
Country	:	US
Telephone Number	:	623-500-2409
Fax Number	:

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

Provider Enumeration Date	:	09/08/2017
Last Update Date	:	09/08/2017

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Directions to “ AMBER READEL ” Practice Location

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