Provider Demographics
NPI:1649089681
Name:BUZIBA, PAMELA L
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:BUZIBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:LINDSAY
Other - Last Name:OWOMUGISHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4021 MCGINNIS FERRY RD APT 1923A
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-8418
Mailing Address - Country:US
Mailing Address - Phone:803-552-4092
Mailing Address - Fax:
Practice Address - Street 1:4021 MCGINNIS FERRY RD APT 1923A
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8418
Practice Address - Country:US
Practice Address - Phone:803-552-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician