Provider Demographics
NPI:1366642241
Name:HARWOOD, PAMELA JEAN (MFT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:HARWOOD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 CHEESE FACTORY RD
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9220
Mailing Address - Country:US
Mailing Address - Phone:585-582-6360
Mailing Address - Fax:585-582-6360
Practice Address - Street 1:169 CHEESE FACTORY RD
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-9220
Practice Address - Country:US
Practice Address - Phone:585-582-6360
Practice Address - Fax:585-582-6360
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0007071106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist