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General NPI Number Information
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NPI Number | 1114029568
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Entity Type | Individual
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Provider Name | PAMELA JANE ROOT-BAECHLE LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 509 ALLEGHENY ST
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City | HOLLIDAYSBURG
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State | PA
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Zip | 16648-2012
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Country | US
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Telephone | 814-695-2776
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Fax | 814-693-9865
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Provider Business Mailing Address
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Address Line | 408 UNION ST
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City | HOLLIDAYSBURG
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State | PA
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Zip | 16648-1518
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Country | US
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Telephone | 814-695-2776
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Fax | 814-693-9865
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CW-002127-L
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License Number State | PA
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