Provider Demographics
NPI:1063649259
Name:ABNER, PAMELA FAITH (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:FAITH
Last Name:ABNER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 HIWASSEE HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-7503
Mailing Address - Country:US
Mailing Address - Phone:423-434-0524
Mailing Address - Fax:423-282-9319
Practice Address - Street 1:301 WESLEY ST STE 1
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1721
Practice Address - Country:US
Practice Address - Phone:423-282-1700
Practice Address - Fax:423-282-9319
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002253235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist