Provider Demographics
NPI:1184828865
Name:HOWARD, PAMELA S (TBVI, ATP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:S
Last Name:HOWARD
Suffix:
Gender:F
Credentials:TBVI, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:OLIVE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:41164-8548
Mailing Address - Country:US
Mailing Address - Phone:606-475-9077
Mailing Address - Fax:606-929-2143
Practice Address - Street 1:194 DAVIS DRIVE
Practice Address - Street 2:
Practice Address - City:OLIVE HILL
Practice Address - State:KY
Practice Address - Zip Code:41164-8548
Practice Address - Country:US
Practice Address - Phone:606-475-9077
Practice Address - Fax:606-929-2143
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist