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General NPI Number Information
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NPI Number | 1386950160
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Entity Type | Organization
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Legal Business Name | PAMELA A KOHN, INC
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 2621 W WACKERLY ST SUITE B
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City | MIDLAND
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State | MI
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Zip | 48640-6993
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Country | US
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Telephone | 989-486-3741
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Fax | 989-486-3742
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Provider Business Mailing Address
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Address Line | 2621 W WACKERLY ST SUITE B
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City | MIDLAND
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State | MI
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Zip | 48640-6993
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Country | US
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Telephone | 989-486-3741
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Fax | 989-486-3742
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PAMELA ANN KOHN
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Credential | LMSW ACSW
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Telephone | 989-486-3741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 6802081567
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License Number State | MI
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