Provider Demographics
NPI:1922298587
Name:HAMM, PAMELA SUE (RN,MS,LPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:HAMM
Suffix:
Gender:F
Credentials:RN,MS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W279S4343 SAYLESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-6802
Mailing Address - Country:US
Mailing Address - Phone:414-350-0931
Mailing Address - Fax:
Practice Address - Street 1:101 W BROADWAY
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-4833
Practice Address - Country:US
Practice Address - Phone:262-547-5567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3925101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional