Provider Demographics
NPI:1619943925
Name:REED, PAMELA ARLENE (PSYD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ARLENE
Last Name:REED
Suffix:
Gender:F
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13965 N STATE ROAD 67
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-8354
Mailing Address - Country:US
Mailing Address - Phone:317-831-2686
Mailing Address - Fax:317-831-2669
Practice Address - Street 1:13965 N STATE ROAD 67
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-8354
Practice Address - Country:US
Practice Address - Phone:317-831-2686
Practice Address - Fax:317-831-2669
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000453A101YM0800X
IN20042119A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health