Provider Demographics
NPI:1063632677
Name:OROSAN-WEINE, PAMELA G (PHD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:G
Last Name:OROSAN-WEINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:G
Other - Last Name:OROSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2350 WASHTENAW AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4525
Mailing Address - Country:US
Mailing Address - Phone:734-769-8050
Mailing Address - Fax:
Practice Address - Street 1:2350 WASHTENAW AVE STE 2
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4525
Practice Address - Country:US
Practice Address - Phone:734-769-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010082103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical