Provider Demographics
NPI:1912048919
Name:LOHSE, PAMELA GAIL
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:GAIL
Last Name:LOHSE
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 1:726 APRICOT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-0103
Mailing Address - Country:US
Mailing Address - Phone:636-946-4333
Mailing Address - Fax:636-724-4333
Practice Address - Street 1:726 APRICOT DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-0103
Practice Address - Country:US
Practice Address - Phone:636-946-4333
Practice Address - Fax:636-724-4333
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO123235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist