Provider Demographics
NPI:1821379967
Name:TROESTER, PAMELA (LCDC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:TROESTER
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:SUE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1430 COLLIER ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2911
Mailing Address - Country:US
Mailing Address - Phone:512-472-4357
Mailing Address - Fax:512-703-1394
Practice Address - Street 1:4019 MANCHACA RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6737
Practice Address - Country:US
Practice Address - Phone:512-472-4337
Practice Address - Fax:512-703-1394
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11042101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)