Provider Demographics
NPI:1992905319
Name:OATWAY, PAMELA M (LCPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:OATWAY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8023 WATERMILL CT
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6146
Mailing Address - Country:US
Mailing Address - Phone:443-755-0752
Mailing Address - Fax:
Practice Address - Street 1:8023 WATERMILL CT
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6146
Practice Address - Country:US
Practice Address - Phone:443-755-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCPC0953101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional