Provider Demographics
NPI:1336120617
Name:PEROS, PAMELA GRACE (LCSW, QCSW)
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:GRACE
Last Name:PEROS
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Gender:F
Credentials:LCSW, QCSW
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Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS
Mailing Address - City:TRIPLER AMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-2460
Mailing Address - Fax:808-433-1558
Practice Address - Street 1:U.S. ARMY HEALTH CLINIC - SCHOFIELD BARRACKS
Practice Address - Street 2:BUILDING #681 - 2ND FLOOR
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96857
Practice Address - Country:US
Practice Address - Phone:808-433-8565
Practice Address - Fax:808-433-8551
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
HI32151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical