Doctor Name: | PAMELA C HANCOCK |
NPI Number: | 1063744274 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, ATR |
License Number: | 4759 |
Business Practice Address: | 136 S. Tomboy St. #107 Pamela C Hancock Telluride, CO - 81435 |
Business Phone Number: | 9707284989 |
Business Fax Number: | 9707284989 |
Mailing Address: | Po Box 1377, TELLURIDE |
State: | CO |
Postal Code: | 814351377 |
Phone Number: | 9707284989 |
Fax Number: | 9707284989 |
NPI Enumeration Date: | 02/12/2010 |
NPI Last Update Date: | 02/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 4759 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |