Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | AZ2744 | AZ |
NPI | 1003019688 |
---|---|
Provider Name | Pamela Diane Suma |
First Address | Sun City, AZ 85351-3048 |
Second Address | Sun City, AZ 85351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 04/10/2018 |