Individual
PAMELA PEGRAM BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CSAC
Contact information
Practice address
1116 COVINGTON RD, COLONIAL HEIGHTS, VA 23834-2714
(804) 387-3818
Mailing address
1116 COVINGTON RD, COLONIAL HEIGHTS, VA 23834-2714
(804) 387-3818
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1215061
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215061
—
VA
Enumeration date
10/28/2018
Last updated
10/28/2018
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