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General NPI Number Information
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NPI Number | 1558587055
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Entity Type | Organization
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Legal Business Name | PAMELA J MEEDS PSY D PA
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 116 S MAIN ST SUITE 207
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City | MOORESVILLE
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State | NC
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Zip | 28115-2372
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Country | US
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Telephone | 704-662-0124
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Fax | 704-662-9192
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Provider Business Mailing Address
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Address Line | 116 S MAIN ST SUITE 207
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City | MOORESVILLE
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State | NC
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Zip | 28115-2372
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Country | US
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Telephone | 704-662-0124
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Fax | 704-662-9192
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAMELA JANE MEEDS
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Credential | PSY.D.
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Telephone | 704-662-0124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0220
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License Number State | NC
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