Provider Demographics
NPI:1750030680
Name:DENNIS, PAMYLA MARIE (CCC, CPS, BA)
Entity Type:Individual
Prefix:
First Name:PAMYLA
Middle Name:MARIE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:CCC, CPS, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7388 ASTER AVE
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-3705
Mailing Address - Country:US
Mailing Address - Phone:760-265-8086
Mailing Address - Fax:
Practice Address - Street 1:7388 ASTER AVE
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3705
Practice Address - Country:US
Practice Address - Phone:760-265-8086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist