Provider Demographics
NPI:1417378571
Name:PAMER, LAURA BOWMAN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BOWMAN
Last Name:PAMER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 N CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-4169
Mailing Address - Country:US
Mailing Address - Phone:727-641-1410
Mailing Address - Fax:
Practice Address - Street 1:2225 A1A S STE B
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-2916
Practice Address - Country:US
Practice Address - Phone:727-641-1410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health