Provider Demographics
NPI:1730499104
Name:MILLER, PAMELA JOYCE (PLPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JOYCE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 41
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067
Mailing Address - Country:US
Mailing Address - Phone:816-616-2812
Mailing Address - Fax:816-240-8296
Practice Address - Street 1:406 A N. 4TH STREET
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:MO
Practice Address - Zip Code:64076
Practice Address - Country:US
Practice Address - Phone:816-616-2812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010029495101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional