Healthcare Provider Details

I. General information

NPI: 1396980439
Provider Name (Legal Business Name): PAMELA DIANE VRANA M.S., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E RUSK ST SUITE 105
ROCKWALL TX
75087-3725
US

IV. Provider business mailing address

9651 COUNTY ROAD 2470
ROYSE CITY TX
75189-6788
US

V. Phone/Fax

Practice location:
  • Phone: 214-546-4216
  • Fax:
Mailing address:
  • Phone: 214-546-4216
  • Fax: 469-698-2668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number60247
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: