Provider Demographics
NPI:1780989020
Name:LEMERAND, PAMELA ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ANNE
Last Name:LEMERAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CORNELL STREET
Mailing Address - Street 2:AUTISM COLLABORATIVE CENTER
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197
Mailing Address - Country:US
Mailing Address - Phone:734-485-2890
Mailing Address - Fax:734-458-2892
Practice Address - Street 1:1055 CORNELL RD
Practice Address - Street 2:AUTISM COLLABORATIVE CENTER
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1657
Practice Address - Country:US
Practice Address - Phone:734-485-2890
Practice Address - Fax:734-458-2892
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005921103TB0200X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral