Individual
PAMELA L HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
1800 HOLLISTER DR, SUITE 205, LIBERTYVILLE, IL 60048-5263
(847) 918-7947
(847) 918-9622
Mailing address
1800 HOLLISTER DR, SUITE 205, LIBERTYVILLE, IL 60048-5263
(847) 918-7947
(847) 918-9622
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3811-026
WI
225X00000X
Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40844900
—
WI
Enumeration date
12/29/2005
Last updated
12/11/2007
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