Provider Demographics
NPI:1447393665
Name:MONAST, PAMELA JEAN (ST)
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:JEAN
Last Name:MONAST
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17900 NW 5TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2809
Mailing Address - Country:US
Mailing Address - Phone:954-435-9905
Mailing Address - Fax:954-435-3769
Practice Address - Street 1:17900 NW 5TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2809
Practice Address - Country:US
Practice Address - Phone:954-435-9905
Practice Address - Fax:954-435-3769
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2787235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist