Provider Demographics
NPI:1578567442
Name:MECHLER-CLINKENBEARD, PAMELA A (OT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:A
Last Name:MECHLER-CLINKENBEARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:A
Other - Last Name:MECHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:5475 WOODHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-5113
Mailing Address - Country:US
Mailing Address - Phone:513-347-9773
Mailing Address - Fax:
Practice Address - Street 1:6566 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-4410
Practice Address - Country:US
Practice Address - Phone:513-547-5400
Practice Address - Fax:513-574-6222
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT04904225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4152551Medicare ID - Type Unspecified