Provider Demographics
NPI:1821347790
Name:LUBING, PAMELA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:LUBING
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 1:365 W PATRICK ST FL 205
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4870
Mailing Address - Country:US
Mailing Address - Phone:402-750-6467
Mailing Address - Fax:
Practice Address - Street 1:365 W PATRICK ST FL 205
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4870
Practice Address - Country:US
Practice Address - Phone:402-750-6467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05881103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical