MEDICARE: MS. PAMELA MARIE SPALLACCI LMFT, MSED

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	106H00000X	Marriage & Family Therapist	001660	NY

General Provider Information

NPI Number	:	1437776721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA MARIE SPALLACCI LMFT, MSED

Provider Business Mailing Address
First Line	:	318 WESTMINSTER RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-3233
Country	:	US
Telephone Number	:	585-402-1755
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 WESTMINSTER RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-3233
Country	:	US
Telephone Number	:	585-402-1755
Fax Number	:

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

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	07/02/2020

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