Provider Demographics
NPI:1699844688
Name:BILODEAU, PAMELA ANN (MS LPC)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:BILODEAU
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 N GRAND AVE
Mailing Address - Street 2:STE 302
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186
Mailing Address - Country:US
Mailing Address - Phone:262-542-3255
Mailing Address - Fax:262-542-0823
Practice Address - Street 1:741 N GRAND AVE
Practice Address - Street 2:STE 302
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186
Practice Address - Country:US
Practice Address - Phone:262-542-3255
Practice Address - Fax:262-542-0823
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1171125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional