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NPI Profile for PAMELA S WATERMAN in DECATUR, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI # | 1407001357 |
|
| Status | Active | |
| Credentials | MA, LCPC | |
| Entity | Individual | |
| Enumeration date | 11/19/2008 | |
| Last updated | 11/19/2008 - About 18 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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PAMELA S WATERMAN
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PAMELA S WATERMAN, MA, LCPC