Provider Demographics
NPI:1558653964
Name:MILLER-GIRTON, PAMELA (RN, LISW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:MILLER-GIRTON
Suffix:
Gender:F
Credentials:RN, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 WINDSOR PARK DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4112
Mailing Address - Country:US
Mailing Address - Phone:937-867-4325
Mailing Address - Fax:937-619-7029
Practice Address - Street 1:537 WINDSOR PARK DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4112
Practice Address - Country:US
Practice Address - Phone:937-867-4325
Practice Address - Fax:937-619-7029
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 10000096104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker