Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 102918 | NC |
Y | 103G00000X | Clinical Psychologist | 102918 | NC |
Y | 103TC0700X | Clinical Psychologist | 102918 | NC |
N | 103TH0100X | Health Service | 102918 | NC |
NPI | 1336320993 |
---|---|
Provider Name | Dr. Pamela S. Perkins |
First Address | Wake Forest, NC 27587-6090 |
Second Address | Wake Forest, NC 27587-9390 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2007 |
Last Update Date | 21/12/2016 |