Provider Demographics
NPI:1710329388
Name:REED-ROY, PAMMIE DENTIA
Entity Type:Individual
Prefix:
First Name:PAMMIE
Middle Name:DENTIA
Last Name:REED-ROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAMMIE
Other - Middle Name:DANTIA
Other - Last Name:REED-ROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1240 W. OWENS AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106
Mailing Address - Country:US
Mailing Address - Phone:702-877-9850
Mailing Address - Fax:702-877-9850
Practice Address - Street 1:1240 W. OWENS AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106
Practice Address - Country:US
Practice Address - Phone:702-877-9850
Practice Address - Fax:702-877-9870
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health