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General NPI Number Information
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NPI Number | 1619372190
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Entity Type | Organization
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Legal Business Name | PAMELA A. BAKER LMHC,LPC,NCC INC
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 605 W BLOOMINGDALE AVE
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City | BRANDON
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State | FL
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Zip | 33511-7444
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Country | US
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Telephone | 828-342-1965
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Fax | 813-684-1987
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Provider Business Mailing Address
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Address Line | 234 BRYAN OAK AVE
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City | BRANDON
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State | FL
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Zip | 33511-7595
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Country | US
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Telephone | 828-342-1965
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Fax | 813-684-1987
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Authorized Official
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Title or Position | OWNER
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Name | MS. PAMELA ANNE BAKER
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Credential | LMHC,LPC
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Telephone | 828-342-1965
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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 | MH3564
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License Number State | FL
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