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NPI Code Detail

MEDICARE: MS. PAMELA WILLIAMS PETERS M.A., L.M.H.C.

MEDICARE:  MS. PAMELA WILLIAMS PETERS  M.A., L.M.H.C.
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
1101Y00000XCounselorMH10843FL

General Provider Information

NPI Number : 1912280991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAMELA WILLIAMS PETERS M.A., L.M.H.C.
Provider Business Mailing Address
First Line : PO BOX 152405
Second Line :
City : CAPE CORAL
State : FL
Zip : 33915-2405
Country : US
Telephone Number : 239-574-4387
Fax Number :
Provider Business Practice Location Address
First Line : 2204 BREVARD AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-3518
Country : US
Telephone Number : 239-574-4387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2011
Last Update Date : 09/26/2011

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Directions to “ MS. PAMELA WILLIAMS PETERS M.A., L.M.H.C.” Practice Location

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