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General NPI Number Information
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NPI Number | 1275839052
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Entity Type | Individual
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Provider Name | PAMELA OPAL ROUSE LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 3 CLOISTER CT
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City | AMHERST
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State | NY
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Zip | 14226-4105
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Country | US
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Telephone | 716-777-1588
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Fax |
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Provider Business Mailing Address
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Address Line | 3 CLOISTER CT
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City | AMHERST
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State | NY
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Zip | 14226-4105
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Country | US
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Telephone | 716-777-1588
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 060485-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 72060485
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License Number State | NY
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