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General NPI Number Information
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NPI Number | 1285792531
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Entity Type | Individual
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Provider Name | PAMELA HOLLAND LCPC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 15 BIRCH ISLAND RD
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City | BRUNSWICK
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State | ME
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Zip | 04011-8142
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Country | US
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Telephone | 207-729-0709
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Fax | 207-725-4857
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Provider Business Mailing Address
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Address Line | PO BOX 916
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City | BRUNSWICK
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State | ME
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Zip | 04011
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Country | US
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Telephone | 207-729-0709
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3508232
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License Number State | ME
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