Green, Pamela

Green, Pamela is an sole proprietor health care provider with primary practice located at 11325 Lake Underhill Rd Ste 101 , Orlando FL 32825-5090. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Green, Pamela can be contacted via phone (407) 365-2599.

Contact Information

Primary practice address
11325 Lake Underhill Rd Ste 101 Orlando FL 32825-5090
Phone: (407) 365-2599
Fax: (407) 365-3132
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PY0002246 Florida
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X PY0002246 Florida
Behavioral Health & Social Service Providers / Forensic 103TF0200X PY0002246 Florida
Behavioral Health & Social Service Providers / Health Service 103TH0100X PY0002246 Florida
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY0002246 Florida

Profile Details

NPI number 1487873717
LBN Legal business name Green, Pamela
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2007
Last updated Feb 7th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487873717 NPPES
Florida MEDICAID 009418900
Florida MEDICAID 209749400

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