Reynolds, Pamela K
Reynolds, Pamela K is an individual health care provider with primary practice located at 1005 Jackson Street , Lacrosse WI 54601. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Reynolds, Pamela K can be contacted via phone (608) 791-6147.Contact Information
Primary practice address
1005 Jackson Street
Lacrosse WI 54601
Phone: (608) 791-6147
Fax: (608) 791-9511
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1305 | Wisconsin |
Profile Details
NPI number | 1720028640 |
---|---|
LBN Legal business name | Reynolds, Pamela K |
Credentials | CADC III CC5G |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 8th, 2006 |
Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1720028640 | NPPES |
Wisconsin | MEDICAID | 39365500 |
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