Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | LC0744 | MD |
NPI | 1003144965 |
---|---|
Provider Name | Mrs. Pamela Warwick Hewetson |
First Address | Frederick, MD 21701-4029 |
Second Address | Frederick, MD 21701-4029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2009 |
Last Update Date | 03/12/2009 |