Provider Demographics
NPI:1578645172
Name:ROOS, PAMELA G (MSSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:G
Last Name:ROOS
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:G
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2301 OHIO DRIVE
Mailing Address - Street 2:SUITE 282
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:972-509-1570
Mailing Address - Fax:
Practice Address - Street 1:2301 OHIO DRIVE
Practice Address - Street 2:SUITE 282
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-509-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX522743104100000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry