Provider Demographics
NPI:1164700555
Name:STEVENS, PAMELA K I (BACHELOR OF MUSIC ED)
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:K
Last Name:STEVENS
Suffix:I
Gender:F
Credentials:BACHELOR OF MUSIC ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 705
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:OK
Mailing Address - Zip Code:73857-9781
Mailing Address - Country:US
Mailing Address - Phone:580-334-1662
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 705
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:OK
Practice Address - Zip Code:73857-9781
Practice Address - Country:US
Practice Address - Phone:580-334-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor