Provider Demographics
NPI:1154692895
Name:PFEFFER, DONNA (MED, LPC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:PFEFFER
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 ALLANDALE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-1008
Mailing Address - Country:US
Mailing Address - Phone:512-917-5922
Mailing Address - Fax:
Practice Address - Street 1:3409 EXECUTIVE CENTER DR STE 210
Practice Address - Street 2:BUCHANAN BUILDING
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1641
Practice Address - Country:US
Practice Address - Phone:512-917-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64346101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor