Provider Demographics
NPI:1164933453
Name:RAMSFIELD, PAMELA R
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:R
Last Name:RAMSFIELD
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 1:1747 N COLLEGE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2606
Mailing Address - Country:US
Mailing Address - Phone:479-305-2907
Mailing Address - Fax:
Practice Address - Street 1:1747 N COLLEGE AVE STE A
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2606
Practice Address - Country:US
Practice Address - Phone:479-305-2907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
AR7808-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker