Provider Demographics
NPI:1184865503
Name:GILL, PAMELA LYNN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LYNN
Last Name:GILL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:LYNN
Other - Last Name:PUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3501 SILVERSIDE ROAD
Mailing Address - Street 2:CONCORD PLAZE - NAAMANS BUILDING
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:610-716-0154
Mailing Address - Fax:
Practice Address - Street 1:3501 SILVERSIDE ROAD
Practice Address - Street 2:CONCORD PLAZE - NAAMANS BUILDING
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810
Practice Address - Country:US
Practice Address - Phone:610-716-0154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-14
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-000140225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist