Provider Demographics
NPI:1649626839
Name:DICARLO, PAMELA MECHELE
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MECHELE
Last Name:DICARLO
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 1:5516 FENWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3976
Mailing Address - Country:US
Mailing Address - Phone:412-849-8209
Mailing Address - Fax:
Practice Address - Street 1:5516 FENWAY DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3976
Practice Address - Country:US
Practice Address - Phone:704-785-0560
Practice Address - Fax:704-824-3999
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11839235Z00000X
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist