Provider Demographics
NPI:1477281442
Name:MULUMBY, PAMELA AUMA
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:AUMA
Last Name:MULUMBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5802 OSWAGO CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-2840
Mailing Address - Country:US
Mailing Address - Phone:573-529-4708
Mailing Address - Fax:
Practice Address - Street 1:5802 OSWAGO CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-2840
Practice Address - Country:US
Practice Address - Phone:573-529-4708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities