Provider Demographics
NPI:1528144565
Name:RICE, PAMELA A (EDD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:A
Last Name:RICE
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 TALLAHASSEE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-3144
Mailing Address - Country:US
Mailing Address - Phone:410-580-2886
Mailing Address - Fax:410-580-5410
Practice Address - Street 1:4 SUDBROOK LN
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4117
Practice Address - Country:US
Practice Address - Phone:410-580-2886
Practice Address - Fax:410-580-5410
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD144303800Medicaid
MD144303801Medicaid