Individual
PAMELA BASTIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP-PMHNP-BC
Contact information
Practice address
10770 N 46TH ST, TAMPA, FL 33617-3442
(813) 631-2516
Mailing address
10770 N 46TH ST, TAMPA, FL 33617-3442
(813) 631-2516
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RN9297409
FL
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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