Provider Demographics
NPI:1922151018
Name:ROWE, PAMELA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2957 W STATE ROAD 434 STE 100
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4453
Mailing Address - Country:US
Mailing Address - Phone:407-928-2538
Mailing Address - Fax:407-264-8344
Practice Address - Street 1:2957 W STATE ROAD 434 STE 100
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4453
Practice Address - Country:US
Practice Address - Phone:407-928-2538
Practice Address - Fax:321-284-8005
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6505235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16236400Medicaid