Provider Demographics
NPI:1174810469
Name:BETTNER, PAMELA (PTA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:BETTNER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:PALMIERI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7299 KIRKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45233-4232
Mailing Address - Country:US
Mailing Address - Phone:513-941-4378
Mailing Address - Fax:
Practice Address - Street 1:8650 GOVERNORS HILL DR STE 180
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-1399
Practice Address - Country:US
Practice Address - Phone:513-791-5766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA.01423171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor