Individual
MS. PAMELA K WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW MSW
Contact information
Practice address
26 MIDWAY, BRISTOL, TN 37620
(423) 989-4500
(423) 989-4582
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW4499
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334969
VALUE OPTIONS
—
01
—
4125310
MAGELLAN SUMMIT
—
Enumeration date
08/14/2006
Last updated
07/08/2007
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