Basic Information
| Provider Information | |||||||||
| NPI: | 1942673827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMSON | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 899 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432051156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6149289400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 899 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432051156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6149289400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2015 | ||||||||
| LastUpdateDate: | 11/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | C 0700378 | OH | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.