Provider Demographics
NPI:1689753972
Name:WILLIAMS, PAMELA SUE (BS AA AS IECE)
Entity Type:Individual
Prefix:PROF
First Name:PAMELA
Middle Name:SUE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BS AA AS IECE
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:98 ANDY'S XING
Mailing Address - Street 2:
Mailing Address - City:CHAVIES
Mailing Address - State:KY
Mailing Address - Zip Code:41727
Mailing Address - Country:US
Mailing Address - Phone:606-435-0064
Mailing Address - Fax:606-435-0064
Practice Address - Street 1:98 ANDY'S XING
Practice Address - Street 2:
Practice Address - City:CHAVIES
Practice Address - State:KY
Practice Address - Zip Code:41727
Practice Address - Country:US
Practice Address - Phone:606-435-0064
Practice Address - Fax:606-435-0064
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY488OtherDEVELOPMENTAL INTERVENTIO