Provider Demographics
NPI:1003144965
Name:HEWETSON, PAMELA WARWICK (MS)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:WARWICK
Last Name:HEWETSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:WORTHINGTON
Other - Last Name:WARWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:703 W. PATRICK ST.
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4029
Mailing Address - Country:US
Mailing Address - Phone:301-662-8908
Mailing Address - Fax:301-662-3308
Practice Address - Street 1:703 W. PATRICK ST.
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4029
Practice Address - Country:US
Practice Address - Phone:301-662-8908
Practice Address - Fax:301-662-3308
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0744101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor