Healthcare Provider Details

I. General information

NPI: 1144737701
Provider Name (Legal Business Name): PAMELA ANN HLAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 ELMHURST BLVD
SALINA KS
67401-7405
US

IV. Provider business mailing address

809 ELMHURST BLVD
SALINA KS
67401-7405
US

V. Phone/Fax

Practice location:
  • Phone: 785-823-6322
  • Fax: 785-823-3109
Mailing address:
  • Phone: 785-823-6322
  • Fax: 785-823-3109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3204
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3241
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number03084
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: