Healthcare Provider Details

I. General information

NPI: 1477840940
Provider Name (Legal Business Name): PAMELA B. POMETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2298 ROYAL LN
NAPLES FL
34112-5323
US

IV. Provider business mailing address

2298 ROYAL LN
NAPLES FL
34112-5323
US

V. Phone/Fax

Practice location:
  • Phone: 508-776-3923
  • Fax:
Mailing address:
  • Phone: 508-776-3923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: