Provider Demographics
NPI:1477840940
Name:POMETTI, PAMELA B
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:B
Last Name:POMETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2298 ROYAL LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-5323
Mailing Address - Country:US
Mailing Address - Phone:508-776-3923
Mailing Address - Fax:
Practice Address - Street 1:2298 ROYAL LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-5323
Practice Address - Country:US
Practice Address - Phone:508-776-3923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS952103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool