Provider Demographics
NPI:1215408232
Name:GLATFELTER, PAMELA D (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:GLATFELTER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:D
Other - Last Name:SUDBRINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:5810 OAKDALE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:IJAMSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21754-9713
Mailing Address - Country:US
Mailing Address - Phone:240-236-5570
Mailing Address - Fax:
Practice Address - Street 1:5810 OAKDALE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:IJAMSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21754-9713
Practice Address - Country:US
Practice Address - Phone:240-236-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06195235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist