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NPI Code Detail

MEDICARE: PAMELA KAY HUFFMAN LLMSW

MEDICARE: PAMELA KAY HUFFMAN LLMSW
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
1104100000XSocial Worker6801086056MI

General Provider Information

NPI Number : 1356420657
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA KAY HUFFMAN LLMSW
Provider Business Mailing Address
First Line : 300 68TH ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49548-6927
Country : US
Telephone Number : 616-455-5000
Fax Number :
Provider Business Practice Location Address
First Line : 2303 KALAMAZOO AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-3780
Country : US
Telephone Number : 616-242-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 07/08/2007

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Directions to “ PAMELA KAY HUFFMAN LLMSW” Practice Location

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