Provider Demographics
NPI:1811795602
Name:SPICHER, PAMELA JEWEL (RBT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEWEL
Last Name:SPICHER
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9795 HIGHWAY 142
Mailing Address - Street 2:
Mailing Address - City:STANTONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38379-5314
Mailing Address - Country:US
Mailing Address - Phone:731-439-5947
Mailing Address - Fax:
Practice Address - Street 1:79 SAND PEBBLE DR STE A
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-7591
Practice Address - Country:US
Practice Address - Phone:901-443-9146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician