| Doctor Name: | PAMELA MOOREHEAD |
| NPI Number: | 1063519791 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISAC |
| License Number: | LISAC-10811 |
| Business Practice Address: | 13549 N Sanders Rd Marana, AZ - 85653 |
| Business Phone Number: | 5206821091 |
| Business Fax Number: | 5206824132 |
| Mailing Address: | Po Box 188, MARANA |
| State: | AZ |
| Postal Code: | 856530188 |
| Phone Number: | 5206824111 |
| Fax Number: | 5206824570 |
| NPI Enumeration Date: | 09/17/2006 |
| NPI Last Update Date: | 07/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LISAC-10811 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |