Provider Demographics
NPI:1649087503
Name:PAPAEMANUEL, VICKI D (PHD)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:D
Last Name:PAPAEMANUEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7325 GULF WAY
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-3954
Mailing Address - Country:US
Mailing Address - Phone:727-967-2387
Mailing Address - Fax:
Practice Address - Street 1:8520 GOVERNMENT DR STE 1
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5511
Practice Address - Country:US
Practice Address - Phone:727-967-2387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY12289103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist