Provider Demographics
NPI:1205093044
Name:DAIUTO, PAMELA M (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:M
Last Name:DAIUTO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:M
Other - Last Name:SLOAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8504 SLABSTONE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7485
Mailing Address - Country:US
Mailing Address - Phone:919-260-1256
Mailing Address - Fax:
Practice Address - Street 1:8504 SLABSTONE CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7485
Practice Address - Country:US
Practice Address - Phone:919-260-1256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4841235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7411492Medicaid