Provider Demographics
NPI:1417566761
Name:JASTRABEK, PAMELA (BSW, MPA)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:JASTRABEK
Suffix:
Gender:F
Credentials:BSW, MPA
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:921 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2210
Mailing Address - Country:US
Mailing Address - Phone:313-670-1045
Mailing Address - Fax:313-274-4900
Practice Address - Street 1:2925 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-4825
Practice Address - Country:US
Practice Address - Phone:313-396-5300
Practice Address - Fax:313-396-5353
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator