Provider Demographics
NPI:1487862918
Name:PATTON, PAMELA H (LISW)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:H
Last Name:PATTON
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7358 CENTRAL RD NW
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44680-9001
Mailing Address - Country:US
Mailing Address - Phone:330-878-5876
Mailing Address - Fax:
Practice Address - Street 1:300 MEDICAL PARK DR
Practice Address - Street 2:SUITE 201
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2073
Practice Address - Country:US
Practice Address - Phone:330-343-6909
Practice Address - Fax:330-343-4883
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI4382104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker