Provider Demographics
NPI:1437481678
Name:SMITH, PAMELA FRANCES (OTR/L)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:FRANCES
Last Name:SMITH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:FRANCES
Other - Last Name:MCKENZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1227
Mailing Address - Country:US
Mailing Address - Phone:585-297-1125
Mailing Address - Fax:585-297-1045
Practice Address - Street 1:222 RICHMOND AVE.
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1227
Practice Address - Country:US
Practice Address - Phone:585-297-1125
Practice Address - Fax:585-297-1040
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101481225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist