Provider Demographics
NPI:1194091124
Name:PRESSGROVE, PAMELA MARIE (SLP)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MARIE
Last Name:PRESSGROVE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 SHETLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-7542
Mailing Address - Country:US
Mailing Address - Phone:270-904-1942
Mailing Address - Fax:270-563-3971
Practice Address - Street 1:613 SHETLAND AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-7542
Practice Address - Country:US
Practice Address - Phone:270-904-1942
Practice Address - Fax:270-563-3971
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist