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NPI Code Detail

MEDICARE: PAMELA SUSAN OBERRY L.M.S.W

MEDICARE:   PAMELA SUSAN OBERRY  L.M.S.W
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
11041C0700XClinical Social Worker6801090506MI

General Provider Information

NPI Number : 1538405550
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA SUSAN OBERRY L.M.S.W
Provider Business Mailing Address
First Line : 30685 BARRINGTON ST
Second Line : STE. 140
City : MADISON HEIGHTS
State : MI
Zip : 48071-5111
Country : US
Telephone Number : 248-414-4080
Fax Number : 248-414-4085
Provider Business Practice Location Address
First Line : 30685 BARRINGTON ST
Second Line : STE. 140
City : MADISON HEIGHTS
State : MI
Zip : 48071-5111
Country : US
Telephone Number : 248-414-4080
Fax Number : 248-414-4085
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2012
Last Update Date : 12/19/2012

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Directions to “ PAMELA SUSAN OBERRY L.M.S.W” Practice Location

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