Provider Demographics
NPI:1073093852
Name:VERA, PAMELA H
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:H
Last Name:VERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3785 NW 82ND AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6632
Mailing Address - Country:US
Mailing Address - Phone:786-803-8982
Mailing Address - Fax:786-472-4547
Practice Address - Street 1:3785 NW 82ND AVE STE 408
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6632
Practice Address - Country:US
Practice Address - Phone:786-803-8982
Practice Address - Fax:786-472-4547
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst