Provider Demographics
NPI:1790750644
Name:PRIEBE, PAMELA T (MA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:T
Last Name:PRIEBE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:84 OAK GROVE LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2515
Mailing Address - Country:US
Mailing Address - Phone:936-689-3256
Mailing Address - Fax:936-788-1100
Practice Address - Street 1:1110 N LOOP 336 W
Practice Address - Street 2:250
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1193
Practice Address - Country:US
Practice Address - Phone:936-689-3256
Practice Address - Fax:936-788-1100
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional