Provider Demographics
NPI:1497974455
Name:EILENDER, PAMELA SUE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:SUE
Last Name:EILENDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 CANDLER OAKS LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3714
Mailing Address - Country:US
Mailing Address - Phone:404-371-9490
Mailing Address - Fax:
Practice Address - Street 1:140 CANDLER OAKS LN
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3714
Practice Address - Country:US
Practice Address - Phone:404-371-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002143103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical