Provider Demographics
NPI:1518013325
Name:MORRIS, PAMELA S (MSOTR)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:S
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MSOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 AUBURN CT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-5205
Mailing Address - Country:US
Mailing Address - Phone:303-601-0290
Mailing Address - Fax:
Practice Address - Street 1:1417 AUBURN CT
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-5205
Practice Address - Country:US
Practice Address - Phone:303-601-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1016907225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92276318Medicaid