MEDICARE: PAMELA A SCHUTTER LMFT

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
1	106H00000X	Marriage & Family Therapist	MT1829	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z1292	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1447228424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA A SCHUTTER LMFT

Provider Business Mailing Address
First Line	:	475 W TOWN PL
Second Line	:	SUITE 205 B
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32092-3648
Country	:	US
Telephone Number	:	904-484-2158
Fax Number	:	904-571-2522

Provider Business Practice Location Address
First Line	:	475 WEST TOWN PLACE
Second Line	:	SUITE 205 B
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32092-0116
Country	:	US
Telephone Number	:	904-484-2158
Fax Number	:	904-471-2522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	02/24/2016

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Directions to “ PAMELA A SCHUTTER LMFT” Practice Location

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