Provider Demographics
NPI:1629576764
Name:FRIESENHAHN, PAMELA (RBT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:FRIESENHAHN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:BERGHEIM
Mailing Address - State:TX
Mailing Address - Zip Code:78004-1917
Mailing Address - Country:US
Mailing Address - Phone:210-627-1556
Mailing Address - Fax:
Practice Address - Street 1:14411 LARKSTONE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4728
Practice Address - Country:US
Practice Address - Phone:210-627-1556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician