Provider Demographics
NPI:1013923796
Name:MEEDS, PAMELA JANE (PSY D)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JANE
Last Name:MEEDS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S. MAIN ST.
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-2372
Mailing Address - Country:US
Mailing Address - Phone:704-662-0124
Mailing Address - Fax:704-662-9192
Practice Address - Street 1:116 S. MAIN ST.
Practice Address - Street 2:SUITE 207
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2372
Practice Address - Country:US
Practice Address - Phone:704-662-0124
Practice Address - Fax:704-662-9192
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2226103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0322LOtherBLUCE CROSS OF NC