Individual provider · Type 1 NPI

Amy Provencal, PTA

Physical Therapy Assistant · West Haven, CT

NPI number 1255584561 Active

Practice location

950 Campbell Ave
West Haven, CT 06516-2770

Call (203) 935-5711 Map

Mailing address

139 Charter Oak Ave
East Haven, CT 06512-2704

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X000199 (CT)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1255584561

Amy Provencal, PTA's National Provider Identifier is 1255584561, issued on Oct 30, 2008. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in West Haven, CT. The record was last updated on Oct 30, 2008.