Provider Demographics
NPI:1992763965
Name:DEUSER, PAMELA G (PHD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:G
Last Name:DEUSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1943 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1902
Mailing Address - Country:US
Mailing Address - Phone:614-481-2101
Mailing Address - Fax:614-481-2174
Practice Address - Street 1:1943 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1902
Practice Address - Country:US
Practice Address - Phone:614-481-2101
Practice Address - Fax:614-481-2174
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4225103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0775648Medicaid
OH0775648Medicaid