Individual
PAMELA DIANN FRIEND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1510 N GRAND AVE, TAHLEQUAH, OK 74464-6318
(918) 708-2119
Mailing address
100555 S 4466 RD, GORE, OK 74435-5048
(479) 225-6265
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1442
OK
Other
Enumeration date
03/01/2021
Last updated
03/01/2021
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