Provider Demographics
NPI:1649821489
Name:ROWELL, PAMELA GAIL (LPC)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:GAIL
Last Name:ROWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CARDINAL LN
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75156-5371
Mailing Address - Country:US
Mailing Address - Phone:903-292-3889
Mailing Address - Fax:
Practice Address - Street 1:103 CARDINAL LN
Practice Address - Street 2:
Practice Address - City:MABANK
Practice Address - State:TX
Practice Address - Zip Code:75156-5371
Practice Address - Country:US
Practice Address - Phone:903-292-3889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75469103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling