Provider Demographics
NPI:1194931295
Name:HUEBNER, PAMELA S (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:S
Last Name:HUEBNER
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 1:431 POST RD E
Mailing Address - Street 2:SUITE 20
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4446
Mailing Address - Country:US
Mailing Address - Phone:203-293-4319
Mailing Address - Fax:203-774-1110
Practice Address - Street 1:431 POST RD E
Practice Address - Street 2:SUITE 20
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4446
Practice Address - Country:US
Practice Address - Phone:203-293-4319
Practice Address - Fax:203-774-1110
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical