Provider Demographics
NPI:1477029429
Name:ALDERINK, PAMELA C
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:C
Last Name:ALDERINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 6TH ST E STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1690
Mailing Address - Country:US
Mailing Address - Phone:651-221-0334
Mailing Address - Fax:651-221-4449
Practice Address - Street 1:287 6TH ST E STE 300
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1690
Practice Address - Country:US
Practice Address - Phone:651-221-0334
Practice Address - Fax:651-221-4449
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN301463101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)