Provider Demographics
NPI:1932306966
Name:STARKEY, PAMELA MORTELLARO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:MORTELLARO
Last Name:STARKEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:MARIE
Other - Last Name:MORTELLARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 1975
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-1975
Mailing Address - Country:US
Mailing Address - Phone:606-877-3479
Mailing Address - Fax:606-877-3479
Practice Address - Street 1:1308 WEST FIFTH STREET
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741
Practice Address - Country:US
Practice Address - Phone:606-877-3479
Practice Address - Fax:606-877-3479
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1109103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical