Provider Demographics
NPI:1225632839
Name:CHASE, PAMELA LYNNE (MS)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LYNNE
Last Name:CHASE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:LYNNE
Other - Last Name:BEAUCHAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4045 GROSSE POINT DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2534
Mailing Address - Country:US
Mailing Address - Phone:410-251-9262
Mailing Address - Fax:
Practice Address - Street 1:811 S 2ND ST
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:MD
Practice Address - Zip Code:21875-1782
Practice Address - Country:US
Practice Address - Phone:410-667-5178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02232L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist