Provider Demographics
NPI:1376189498
Name:TESTI, PAMELA GAIL (MFT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:GAIL
Last Name:TESTI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:LAWSON
Other - Last Name:TESTI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:510 S 980 E
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-3948
Mailing Address - Country:US
Mailing Address - Phone:949-485-0580
Mailing Address - Fax:
Practice Address - Street 1:510 S 980 E
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3948
Practice Address - Country:US
Practice Address - Phone:949-485-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-24
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11506008-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist