Provider Demographics
NPI:1912068222
Name:THOMPSON, PAMELA MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:MICHELLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:MICHELLE
Other - Last Name:EVERETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:946 WINBURN DR
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-2853
Mailing Address - Country:US
Mailing Address - Phone:404-761-0690
Mailing Address - Fax:
Practice Address - Street 1:965 WINBURN DR
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-2852
Practice Address - Country:US
Practice Address - Phone:404-644-0710
Practice Address - Fax:770-953-0031
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002611103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical