Basic Information
| Provider Information | |||||||||
| NPI: | 1912043878 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEPPER | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | LASONDRA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 CLOVERLY PL | ||||||||
| Address2: | |||||||||
| City: | SEARCY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721437252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013053108 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3302 E MOORE AVE | ||||||||
| Address2: | |||||||||
| City: | SEARCY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721434886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012684181 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 0618APPL | AR | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.