Individual
MRS. PAMELA MARIE MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
109 WIND HAVEN DR STE 100, NICHOLASVILLE, KY 40356-8010
(859) 619-3984
(859) 224-4675
Mailing address
109 WIND HAVEN DR STE 100, NICHOLASVILLE, KY 40356-8010
(859) 619-3984
(859) 224-4675
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
135225
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100205670
—
KY
01
—
K041170
MEDICARE TIN
KY
Enumeration date
01/25/2007
Last updated
02/20/2017
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