Provider Information for 1851001473
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Mrs. PAMELA SUZANNE GILLEY LCSW
Sex: Female
NPI: 1851001473
Last Updated: 2024-08-27
Certification Date: 2024-08-27
Certification Date: 2024-08-27
Details
Name | Value | ||||||||||||
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NPI | 1851001473 | ||||||||||||
Enumeration Date | 2022-12-05 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 217 S SAN SOUCI BLVD PANAMA CITY BEACH, FL 32413 United States Phone: 678-878-8236 | Fax: | ||||||||||||
Primary Practice Address | 217 S SAN SOUCI BLVD PANAMA CITY BEACH, FL 32413 United States Phone: 678-878-8236 | Fax: | ||||||||||||
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