Provider Demographics
NPI:1780734087
Name:FIRLE, PAMELA JEAN (LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:FIRLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LONG CREEK RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-9303
Mailing Address - Country:US
Mailing Address - Phone:512-334-9324
Mailing Address - Fax:
Practice Address - Street 1:28465 RANCH ROAD 12
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-3795
Practice Address - Country:US
Practice Address - Phone:512-858-2241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18516101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional