Provider Demographics
NPI:1578155727
Name:VENARD, PAMELA DAWN (SWT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DAWN
Last Name:VENARD
Suffix:
Gender:F
Credentials:SWT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1814
Mailing Address - Country:US
Mailing Address - Phone:937-430-3599
Mailing Address - Fax:
Practice Address - Street 1:141 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1814
Practice Address - Country:US
Practice Address - Phone:937-430-3599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2101708104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker