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Individual

PAMELA ANNE RISLEY

Active
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Individual

PAMELA ANNE RISLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I 05566
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00JN33
MESA BLUE CROSS BLUE SHI
NM
01
550010004361
PACIFICARE BEH HEALTH
NM
05
95321781
NM
Enumeration date
04/13/2007
Last updated
07/08/2007
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