Provider Demographics
NPI:1659510543
Name:CLAYPOOL, PAMELA (OT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:CLAYPOOL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 321087
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-1087
Mailing Address - Country:US
Mailing Address - Phone:601-420-6867
Mailing Address - Fax:601-664-1006
Practice Address - Street 1:201 E LAYFAIR DR STE 125
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7646
Practice Address - Country:US
Practice Address - Phone:601-420-6867
Practice Address - Fax:601-664-1006
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0071225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist