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General NPI Number Information
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NPI Number | 1194043067
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Entity Type | Individual
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Provider Name | PAMELA SELBY MOORE LPC
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Gender | Female
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Dates
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Enumeration Date | 05/17/2010
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 15150 PRESTON RD STE 300
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City | DALLAS
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State | TX
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Zip | 75248-4871
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Country | US
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Telephone | 214-433-2865
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Fax |
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Provider Business Mailing Address
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Address Line | 6333 SOUTHPOINT DR
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City | DALLAS
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State | TX
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Zip | 75248-2107
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Country | US
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Telephone | 214-794-4241
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 63921
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License Number State | TX
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