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General NPI Number Information
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NPI Number | 1508140971
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Entity Type | Organization
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Legal Business Name | ENGEDI LIFE CARE, PLLC
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Dates
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Enumeration Date | 10/04/2011
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 201 S LAKELINE BLVD STE 103
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City | CEDAR PARK
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State | TX
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Zip | 78613-2719
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Country | US
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Telephone | 512-528-5356
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Fax |
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Provider Business Mailing Address
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Address Line | 3550 N LAKELINE BLVD STE 170-1515
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City | LEANDER
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State | TX
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Zip | 78641-3504
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Country | US
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Telephone | 512-201-0741
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Fax |
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Authorized Official
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Title or Position | THERAPIST & SOLE OWNER
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Name | PAMELA A BERMENDER
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Credential | LMFT
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Telephone | 512-201-0741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 201504
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License Number State | TX
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