Provider Demographics
NPI:1508101999
Name:TOPPER, PAMELA P (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:P
Last Name:TOPPER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 67 BOX 50
Mailing Address - Street 2:
Mailing Address - City:NOGAL
Mailing Address - State:NM
Mailing Address - Zip Code:88341-9702
Mailing Address - Country:US
Mailing Address - Phone:575-354-2984
Mailing Address - Fax:
Practice Address - Street 1:3010 NORTH FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:ALAMOGRADO
Practice Address - State:NM
Practice Address - Zip Code:88310
Practice Address - Country:US
Practice Address - Phone:575-434-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2980224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant