Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 071.007817 | IL |
Y | 103G00000X | Clinical Psychologist | 071.007817 | IL |
Y | 103TC0700X | Clinical Psychologist | 071.007817 | IL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 071.007817 | IL |
NPI | 1134390503 |
---|---|
Provider Name | Dr. Pamela Constance Hewitt-Meyer |
First Address | Rushville, IL 62681-0085 |
Second Address | Rushville, IL 62681-1324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2008 |
Last Update Date | 11/07/2011 |