Individual
PAMELA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225800000X
Recreation Therapist
—
—
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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