Provider Demographics
NPI:1083870067
Name:CHAMORRO, PAMELA ELIZABETH
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ELIZABETH
Last Name:CHAMORRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GRINDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2210
Mailing Address - Country:US
Mailing Address - Phone:617-584-5942
Mailing Address - Fax:
Practice Address - Street 1:3 GRINDSTONE CT
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2210
Practice Address - Country:US
Practice Address - Phone:617-584-5942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10304791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical