Provider Demographics
NPI:1821329152
Name:ADLER, PAMELA MURRAY
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:MURRAY
Last Name:ADLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 ASHLEY LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2789
Mailing Address - Country:US
Mailing Address - Phone:207-773-1880
Mailing Address - Fax:
Practice Address - Street 1:383 US ROUTE 1
Practice Address - Street 2:BOX 4
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9817
Practice Address - Country:US
Practice Address - Phone:207-883-1211
Practice Address - Fax:207-883-1224
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1508225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist