Healthcare Provider Details

I. General information

NPI: 1598917189
Provider Name (Legal Business Name): PAMELA JEAN SUOMINEN COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAMELA MOSKAL

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 WOODWARD DRIVE
GREENSBURG PA
15601-6414
US

IV. Provider business mailing address

1100 SHAWNEE ROAD
LIMA OH
45805
US

V. Phone/Fax

Practice location:
  • Phone: 724-836-4424
  • Fax: 724-836-4613
Mailing address:
  • Phone: 419-999-2030
  • Fax: 419-991-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOP005854
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code224ZR0403X
TaxonomyDriving and Community Mobility Occupational Therapy Assistant
License NumberOP005854
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: