Basic Information
| Provider Information | |||||||||
| NPI: | 1609270826 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OCAMPO | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | ABRAHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 GRANTSWOOD RD STE 220 | ||||||||
| Address2: | |||||||||
| City: | IRONDALE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352103661 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055209600 | ||||||||
| FaxNumber: | 2053273177 | ||||||||
| Practice Location | |||||||||
| Address1: | 5000 GRANTSWOOD RD STE 220 | ||||||||
| Address2: | |||||||||
| City: | IRONDALE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055209600 | ||||||||
| FaxNumber: | 2053271377 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2014 | ||||||||
| LastUpdateDate: | 05/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 12129 | MA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 056.012125 | IL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 3275 | NM | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.