Provider Demographics
NPI:1992932370
Name:PELDO, PAMELA C (LMFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:C
Last Name:PELDO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 S MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-3223
Mailing Address - Country:US
Mailing Address - Phone:307-751-7900
Mailing Address - Fax:307-675-1997
Practice Address - Street 1:1 E ALGER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-3911
Practice Address - Country:US
Practice Address - Phone:307-675-1999
Practice Address - Fax:307-675-1997
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLMFT-096106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist