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NPI Code Detail

MEDICARE: PAMELA JOANE HEAD

MEDICARE:   PAMELA JOANE HEAD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant1994TN

General Provider Information

NPI Number : 1649807827
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA JOANE HEAD
Provider Business Mailing Address
First Line : 1846 WHITES BEND LN
Second Line :
City : GAINESBORO
State : TN
Zip : 38562-6153
Country : US
Telephone Number : 931-268-3987
Fax Number :
Provider Business Practice Location Address
First Line : 120 PITCOCK LN
Second Line :
City : CELINA
State : TN
Zip : 38551-4058
Country : US
Telephone Number : 931-243-3139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2020
Last Update Date : 03/26/2020

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Directions to “ PAMELA JOANE HEAD ” Practice Location

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