Doctor Name: | MRS. PAMELA SUE ROBERTS |
NPI Number: | 1356610224 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 052586 |
Business Practice Address: | 134 Main St Setauket, NY - 117332833 |
Business Phone Number: | 6317304600 |
Business Fax Number: | |
Mailing Address: | 32 Jefferson Landing Cir, PORT JEFFERSON |
State: | NY |
Postal Code: | 117771989 |
Phone Number: | 6314743285 |
Fax Number: | |
NPI Enumeration Date: | 12/22/2011 |
NPI Last Update Date: | 12/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 052586 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |