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General NPI Number Information
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NPI Number | 1235951773
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Entity Type | Individual
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Provider Name | PAMELA VICTORIA ERVIN
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 6723 US HIGHWAY 27 S
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City | SEBRING
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State | FL
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Zip | 33876-5737
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Country | US
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Telephone | 863-451-8448
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Fax |
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Provider Business Mailing Address
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Address Line | 8024 US HIGHWAY 98
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City | LORIDA
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State | FL
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Zip | 33857-2702
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Country | US
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Telephone | 863-214-4652
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH23664
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License Number State | FL
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