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General NPI Number Information
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NPI Number | 1942485362
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Entity Type | Organization
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Legal Business Name | PT PRIEBE, PLLC
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 1110 N LOOP 336 W STE 250
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City | CONROE
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State | TX
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Zip | 77301-1194
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Country | US
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Telephone | 936-689-3256
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Fax | 936-788-1100
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Provider Business Mailing Address
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Address Line | 84 OAK GROVE LN
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City | CONROE
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State | TX
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Zip | 77304-2515
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Country | US
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Telephone | 936-689-3256
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Fax | 936-788-1100
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. PAMELA T PRIEBE
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Credential | LPC
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Telephone | 936-689-3256
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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 | 13824
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License Number State | TX
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