Provider Demographics
NPI:1588852701
Name:KAIN, PAMELA SUE (PSYD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:KAIN
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 1:2316 PINE RIDGE RD STE 334
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2006
Mailing Address - Country:US
Mailing Address - Phone:239-398-0337
Mailing Address - Fax:239-566-1336
Practice Address - Street 1:2316 PINE RIDGE RD STE 334
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2006
Practice Address - Country:US
Practice Address - Phone:239-398-0337
Practice Address - Fax:239-566-1336
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7579103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist