Provider Demographics
NPI:1235242751
Name:MARKHAM, PAMELA N (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:N
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 GLADES RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4167
Mailing Address - Country:US
Mailing Address - Phone:561-498-8585
Mailing Address - Fax:561-499-8585
Practice Address - Street 1:7900 GLADES RD
Practice Address - Street 2:SUITE 450
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4167
Practice Address - Country:US
Practice Address - Phone:561-498-8585
Practice Address - Fax:561-499-8585
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7365103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAA054ZMedicare ID - Type Unspecified
FLAA054ZMedicare UPIN