Provider Demographics
NPI:1417267642
Name:ASHMORE, PAMALEE JEAN (LSW-C)
Entity Type:Individual
Prefix:
First Name:PAMALEE
Middle Name:JEAN
Last Name:ASHMORE
Suffix:
Gender:F
Credentials:LSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 HANCOCK ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6573
Mailing Address - Country:US
Mailing Address - Phone:207-989-5701
Mailing Address - Fax:207-989-5720
Practice Address - Street 1:304 HANCOCK ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6573
Practice Address - Country:US
Practice Address - Phone:207-989-5701
Practice Address - Fax:207-989-5720
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELSX12784104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker