Provider Demographics
NPI:1235592650
Name:CARPENTER, PAMELA DAWN (MA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DAWN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4154 COUNTY ROAD 52
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-8576
Mailing Address - Country:US
Mailing Address - Phone:740-532-5981
Mailing Address - Fax:
Practice Address - Street 1:302 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1010
Practice Address - Country:US
Practice Address - Phone:740-532-2209
Practice Address - Fax:740-532-3077
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-02
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist