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General NPI Number Information
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NPI Number | 1538998885
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Entity Type | Individual
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Provider Name | PAMELA A ST.VICTOR
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Gender | Female
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Dates
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Enumeration Date | 07/26/2024
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 207 PARK PLACE BLVD STE 2
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City | KISSIMMEE
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State | FL
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Zip | 34741-2373
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Country | US
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Telephone | 407-693-6577
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Fax |
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Provider Business Mailing Address
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Address Line | 14650 BRIGHTWELL CT
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City | ORLANDO
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State | FL
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Zip | 32824-6462
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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