Individual
MS. PAMELA TAYLOR
Active
Individual
MS. PAMELA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-2425876
TRICARE EXTENDED HEALTH CARE OPTION
MO
Enumeration date
08/15/2017
Last updated
07/21/2022
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