Provider Demographics
NPI:1730744657
Name:FRAZIER, PAMELA JOYCE (LPC-INTERN)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JOYCE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 TRINITY MANOR LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-7257
Mailing Address - Country:US
Mailing Address - Phone:314-392-7671
Mailing Address - Fax:
Practice Address - Street 1:2315 TRINITY MANOR LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-7257
Practice Address - Country:US
Practice Address - Phone:314-392-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional