MEDICARE: DR. PAMELA ARLENE REED PSYD, HSPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	39000453A	IN
2	103TC0700X	Clinical Psychologist	20042119A	IN

General Provider Information

NPI Number	:	1619943925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA ARLENE REED PSYD, HSPP

Provider Business Mailing Address
First Line	:	13965 N STATE ROAD 67
Second Line	:
City	:	CAMBY
State	:	IN
Zip	:	46113-8354
Country	:	US
Telephone Number	:	317-831-2686
Fax Number	:	317-831-2669

Provider Business Practice Location Address
First Line	:	13965 N STATE ROAD 67
Second Line	:
City	:	CAMBY
State	:	IN
Zip	:	46113-8354
Country	:	US
Telephone Number	:	317-831-2686
Fax Number	:	317-831-2669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	04/01/2014

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