Provider Demographics
NPI:1619050457
Name:RICHART, PAMELA JANE (MCD CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JANE
Last Name:RICHART
Suffix:
Gender:F
Credentials:MCD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 GREENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5737
Mailing Address - Country:US
Mailing Address - Phone:919-460-9057
Mailing Address - Fax:919-733-0764
Practice Address - Street 1:3601MSC CENTER
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27699-3601
Practice Address - Country:US
Practice Address - Phone:919-715-5871
Practice Address - Fax:919-733-0764
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2376235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist