Provider Demographics
NPI:1114902012
Name:LACHOWSKY, PAMELA ANN (MSE CCCSLP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:LACHOWSKY
Suffix:
Gender:F
Credentials:MSE CCCSLP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:SMITH
Other - Last Name:LACHOWSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:151 GOLDEN OAKS RD
Mailing Address - Street 2:
Mailing Address - City:ZOLFO SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33890-4757
Mailing Address - Country:US
Mailing Address - Phone:863-245-9336
Mailing Address - Fax:863-735-8274
Practice Address - Street 1:151 GOLDEN OAKS RD
Practice Address - Street 2:
Practice Address - City:ZOLFO SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33890-4757
Practice Address - Country:US
Practice Address - Phone:863-245-9336
Practice Address - Fax:863-735-8274
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3510235Z00000X
AL2426235Z00000X
GASLP005110235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist