Provider Demographics
NPI:1801301783
Name:ENGLISH, PAMELA LOUISE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LOUISE
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 S RINCON DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-0055
Mailing Address - Country:US
Mailing Address - Phone:708-308-7654
Mailing Address - Fax:
Practice Address - Street 1:2500 W SAN TAN HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-4814
Practice Address - Country:US
Practice Address - Phone:708-398-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP10938246Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology