Provider Demographics
NPI:1972171742
Name:ZAREMBA, PAMELA KAY
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAY
Last Name:ZAREMBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10922 MANGLOS RD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:MI
Mailing Address - Zip Code:49730-9110
Mailing Address - Country:US
Mailing Address - Phone:231-342-5628
Mailing Address - Fax:
Practice Address - Street 1:10922 MANGLOS RD
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:MI
Practice Address - Zip Code:49730-9110
Practice Address - Country:US
Practice Address - Phone:231-342-5628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician