Basic Information
| Provider Information | |||||||||
| NPI: | 1669653036 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWER | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7550 SOUTH STATE STREET | ||||||||
| Address2: | |||||||||
| City: | LOWVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153765450 | ||||||||
| FaxNumber: | 3153767221 | ||||||||
| Practice Location | |||||||||
| Address1: | 7550 SOUTH STATE STREET | ||||||||
| Address2: | |||||||||
| City: | LOWVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153765450 | ||||||||
| FaxNumber: | 3153767221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2007 | ||||||||
| LastUpdateDate: | 10/25/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 104100000X | 075127 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.