Provider Demographics
NPI:1508273681
Name:MILBRY, PAMELA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:MILBRY
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 1:4612 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-7123
Mailing Address - Country:US
Mailing Address - Phone:813-263-6276
Mailing Address - Fax:
Practice Address - Street 1:4612 N 56TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-7123
Practice Address - Country:US
Practice Address - Phone:813-263-6276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional