Provider Demographics
NPI:1851524839
Name:MUELLER, PAMELA A (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31341 WRENCREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543
Mailing Address - Country:US
Mailing Address - Phone:813-428-2074
Mailing Address - Fax:814-944-6500
Practice Address - Street 1:2241 GREEN HEDGES WAY
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544
Practice Address - Country:US
Practice Address - Phone:813-973-1033
Practice Address - Fax:814-944-6500
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005615L235Z00000X
FLSA14183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019820900Medicaid