Healthcare Provider Details

I. General information

NPI: 1346418050
Provider Name (Legal Business Name): PAMELA PHELAN MEEK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 09/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 EAST WEST HIGHWAY
BETHESDA MD
20814-4433
US

IV. Provider business mailing address

522 ANDERSON AVE
ROCKVILLE MD
20850-2101
US

V. Phone/Fax

Practice location:
  • Phone: 301-412-2830
  • Fax: 301-424-0683
Mailing address:
  • Phone: 301-412-2830
  • Fax: 301-424-0683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1350
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1350
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number1350
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: