Provider Demographics
NPI:1104340850
Name:MEARS, PAMELA MARY (OTR/L)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:MARY
Last Name:MEARS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1275
Mailing Address - Street 2:
Mailing Address - City:EAST GRANBY
Mailing Address - State:CT
Mailing Address - Zip Code:06026-1275
Mailing Address - Country:US
Mailing Address - Phone:860-392-9354
Mailing Address - Fax:
Practice Address - Street 1:3 GRIST MILL LN
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2485
Practice Address - Country:US
Practice Address - Phone:860-392-9354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000514225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics