MEDICARE: PAMELA WANAMAKER SWINSON BEHAVIOR TECHNICIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1285478008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA WANAMAKER SWINSON BEHAVIOR TECHNICIAN

Provider Business Mailing Address
First Line	:	1750 FOREST DR STE 160
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-4211
Country	:	US
Telephone Number	:	888-344-5977
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 FOREST DR STE 160
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-4211
Country	:	US
Telephone Number	:	888-344-5977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	06/24/2025

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Directions to “ PAMELA WANAMAKER SWINSON BEHAVIOR TECHNICIAN” Practice Location

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