Individual
PAMELA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5505 CREEDMOOR RD, SUITE 100, RALEIGH, NC 27612-6333
(919) 852-5352
(919) 852-5323
Mailing address
1609 BELLECHASSE DR, RALEIGH, NC 27615-7401
(919) 852-5352
(919) 852-5323
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
992
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6105065
—
NC
Enumeration date
07/04/2006
Last updated
07/08/2007
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