Provider Demographics
NPI:1518010032
Name:SEIDLER, PAMELA NONE (MS,LPC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:NONE
Last Name:SEIDLER
Suffix:
Gender:F
Credentials:MS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 TOPAZ RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-5153
Mailing Address - Country:US
Mailing Address - Phone:254-553-2271
Mailing Address - Fax:
Practice Address - Street 1:CARL R DARNALL ARMY MEDICAL CENTER 36000 DARNALL LOOP
Practice Address - Street 2:
Practice Address - City:FT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-553-2271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4539101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional