Provider Demographics
NPI:1710197348
Name:SPEVAK, PAMELA JANE (BS EDUCATION)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JANE
Last Name:SPEVAK
Suffix:
Gender:F
Credentials:BS EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E. 8TH ST.
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025
Mailing Address - Country:US
Mailing Address - Phone:402-721-1414
Mailing Address - Fax:412-753-9914
Practice Address - Street 1:212 E. 8TH ST.
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025
Practice Address - Country:US
Practice Address - Phone:402-721-1414
Practice Address - Fax:412-753-9914
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker