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Contact Information

PAMELA MOOREHEAD, LISAC
13549 N SANDERS RD
MARANA, AZ85653
 Phone: 520-682-1091
 Fax: 520-682-4132
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for PAMELA MOOREHEAD · (Female)

NPI # 1063519791
Status Active
Credentials LISAC
Entity Individual
Enumeration date 09/17/2006
Last updated 07/12/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # LISAC-10811
  • AZ Medicaid 164462
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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