Provider Demographics
NPI:1821708298
Name:POACH, PAMELA ANN
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:POACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 COOK RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9622
Mailing Address - Country:US
Mailing Address - Phone:614-204-0702
Mailing Address - Fax:
Practice Address - Street 1:665 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3245
Practice Address - Country:US
Practice Address - Phone:614-846-6265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker