Provider Demographics
NPI:1336459163
Name:WEBSTER, PATRICIA BLEVINS (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:BLEVINS
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 KETCH CT
Mailing Address - Street 2:
Mailing Address - City:ORIENTAL
Mailing Address - State:NC
Mailing Address - Zip Code:28571-9693
Mailing Address - Country:US
Mailing Address - Phone:919-949-1788
Mailing Address - Fax:252-249-2289
Practice Address - Street 1:115 N DUKE ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2185
Practice Address - Country:US
Practice Address - Phone:919-949-1788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2234103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist