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NPI Code Detail

MEDICARE: PAMELA LYNN JUNE PHD

MEDICARE: PAMELA LYNN JUNE PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20040733AIN
2103TC0700XClinical PsychologistPY 9551FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PY9551OTHERFLFL STATE LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306820394
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA LYNN JUNE PHD
Provider Business Mailing Address
First Line : PO BOX 827
Second Line :
City : KATHLEEN
State : FL
Zip : 33849-0827
Country : US
Telephone Number : 317-490-7994
Fax Number :
Provider Business Practice Location Address
First Line : 6804 CECELIA DR
Second Line : SUITE 201
City : NEW PORT RICHEY
State : FL
Zip : 34653-4935
Country : US
Telephone Number : 727-232-0644
Fax Number : 888-546-0488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 10/05/2017

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Directions to “ PAMELA LYNN JUNE PHD” Practice Location

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