Provider Demographics
NPI:1477727212
Name:DIBELLA, PAMELA HELEN (MS-CCC, SLP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:HELEN
Last Name:DIBELLA
Suffix:
Gender:F
Credentials:MS-CCC, SLP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:HELEN
Other - Last Name:ASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS-CCC, SLP
Mailing Address - Street 1:7500 W DEAN RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2638
Mailing Address - Country:US
Mailing Address - Phone:414-371-7394
Mailing Address - Fax:
Practice Address - Street 1:7500 W DEAN RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-2638
Practice Address - Country:US
Practice Address - Phone:414-371-7394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist