Provider Demographics
NPI:1043242464
Name:ESCOBAR, PAMELA ANN (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ANN
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:FARR
Other - Last Name:ESCOBAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:37743 BOUGAINVILLEA AVE
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-4737
Mailing Address - Country:US
Mailing Address - Phone:352-467-0444
Mailing Address - Fax:352-567-9513
Practice Address - Street 1:4353 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-6207
Practice Address - Country:US
Practice Address - Phone:352-467-0444
Practice Address - Fax:352-567-9513
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7563101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor