Provider Demographics
NPI:1912233586
Name:PULLEN, PATRICE NICOLE (MED RMHCI)
Entity type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:NICOLE
Last Name:PULLEN
Suffix:
Gender:F
Credentials:MED RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8730 RIBAULT AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-4914
Mailing Address - Country:US
Mailing Address - Phone:240-375-3332
Mailing Address - Fax:
Practice Address - Street 1:1600 E ROBINSON ST STE 250
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5955
Practice Address - Country:US
Practice Address - Phone:407-423-3327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health