Provider Demographics
NPI:1194278358
Name:PEDEN, AMBER (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PEDEN
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:ROCHELLE
Other - Last Name:HERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LAT, ATC
Mailing Address - Street 1:2218 BRINKERTON RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7258
Mailing Address - Country:US
Mailing Address - Phone:724-674-4886
Mailing Address - Fax:
Practice Address - Street 1:270 CREST AVE
Practice Address - Street 2:
Practice Address - City:ROSTRAVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15012-4200
Practice Address - Country:US
Practice Address - Phone:412-398-5283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer