Provider Demographics
NPI:1033374350
Name:MOYE, PAMELA SIOBOHN (LCAS, MSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SIOBOHN
Last Name:MOYE
Suffix:
Gender:F
Credentials:LCAS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 REVOLUTION MILL DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5065
Mailing Address - Country:US
Mailing Address - Phone:336-457-2355
Mailing Address - Fax:
Practice Address - Street 1:1150 REVOLUTION MILL DR
Practice Address - Street 2:SUITE 11
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5065
Practice Address - Country:US
Practice Address - Phone:336-457-2355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC540101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)