Provider Demographics
NPI:1659617447
Name:BECHIK, PAMELA RAE (MS)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:RAE
Last Name:BECHIK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 KEENAN DR
Mailing Address - Street 2:
Mailing Address - City:INTL FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56649-2181
Mailing Address - Country:US
Mailing Address - Phone:218-285-6228
Mailing Address - Fax:218-285-6278
Practice Address - Street 1:2501 KEENAN DR
Practice Address - Street 2:
Practice Address - City:INTL FALLS
Practice Address - State:MN
Practice Address - Zip Code:56649-2181
Practice Address - Country:US
Practice Address - Phone:218-285-6228
Practice Address - Fax:218-285-6278
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-24
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health