Provider Demographics
NPI:1144334186
Name:CURTIS, PAMELA M (AUD)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:M
Last Name:CURTIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:M
Other - Last Name:STRENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:800 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-2553
Mailing Address - Country:US
Mailing Address - Phone:618-395-7340
Mailing Address - Fax:
Practice Address - Street 1:1200 N EAST ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-2499
Practice Address - Country:US
Practice Address - Phone:618-395-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001185231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P96452Medicare UPIN