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General NPI Number Information
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NPI Number | 1780948562
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Entity Type | Individual
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Provider Name | PAMELA KAY PARKER OT
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Gender | Female
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | HC 1 BOX 9100
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City | SELLS
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State | AZ
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Zip | 85634-9744
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Country | US
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Telephone | 520-361-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 21186 E LIBERTY PL
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City | RED ROCK
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State | AZ
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Zip | 85145-5036
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Country | US
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Telephone | 520-370-1482
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5024
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License Number State | AZ
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