Provider Demographics
NPI:1770673188
Name:FERCH, PAMELA ANN (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ANN
Last Name:FERCH
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 RESTON PL
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4620
Mailing Address - Country:US
Mailing Address - Phone:843-368-7531
Mailing Address - Fax:843-706-2041
Practice Address - Street 1:13 RESTON PL
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4620
Practice Address - Country:US
Practice Address - Phone:843-368-7531
Practice Address - Fax:843-706-2041
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3646OtherSTATE LICENSE SPH LANG
SCSA0599Medicaid