Basic Information
| Provider Information | |||||||||
| NPI: | 1902908239 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEGAL | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | SUE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12644 SHORELINE DR APT 8G | ||||||||
| Address2: | |||||||||
| City: | WELLINGTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334142027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618891522 | ||||||||
| FaxNumber: | 9543169239 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 SE 19TH AVE | ||||||||
| Address2: | BROWARD CHILDREN'S CENTER | ||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545872497 | ||||||||
| FaxNumber: | 9549434115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | OT8552 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.