Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | PC005001 | PA |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | PC005001 CAC, PCB | PA |
N | 101YM0800X | Mental Health Counselor | PC005001 CCDP, PCB | PA |
NPI | 1003049727 |
---|---|
Provider Name | Ms. Pamela Helen Dehart |
First Address | Allentown, PA 18104-3701 |
Second Address | Emmaus, PA 18049-2339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2009 |
Last Update Date | 11/12/2009 |