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Individual

PAMELA VILETTA STOVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1740 E 67 N, LOT 57 B, HUNTINGTON, IN 46750
(219) 386-3600
(219) 386-3660
Mailing address
PO BOX 166, KOUTS, IN 46347-0166
(219) 281-6163
(219) 386-3600

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007467A
IN
1041C0700X
Clinical Social Worker
57798
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300045162
IN
Enumeration date
09/06/2013
Last updated
01/08/2021
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