Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP006547 | PA |
NPI | 1003110644 |
---|---|
Provider Name | Pamela Sue Reid |
First Address | Clarion, PA 16214-2204 |
Second Address | Seneca, PA 16346-2130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2010 |
Last Update Date | 22/12/2010 |