Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 2226 | NC |
Y | 103T00000X | Psychologist | 2226 | NC |
NPI | 1013923796 |
---|---|
Provider Name | Ms. Pamela Jane Meeds |
First Address | Mooresville, NC 28115-2372 |
Second Address | Mooresville, NC 28115-2372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0322L | BLUCE CROSS OF NC (01) | NC |