Healthcare Provider Details

I. General information

NPI: 1609123686
Provider Name (Legal Business Name): PAM REED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13965 N STATE ROAD 67
CAMBY IN
46113-8354
US

IV. Provider business mailing address

13965 N STATE ROAD 67
CAMBY IN
46113-8354
US

V. Phone/Fax

Practice location:
  • Phone: 317-831-2686
  • Fax: 317-831-2669
Mailing address:
  • Phone: 317-831-2686
  • Fax: 317-831-2669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number20042119A
License Number StateIN

VIII. Authorized Official

Name: DR. PAMELA ARLENE REED
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 317-831-2686