Provider Demographics
NPI:1942692546
Name:POUSSON, PAMELA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:POUSSON
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 1:409 KING STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-9139
Mailing Address - Country:US
Mailing Address - Phone:843-724-9947
Mailing Address - Fax:
Practice Address - Street 1:409 KING ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-6426
Practice Address - Country:US
Practice Address - Phone:843-724-9947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist