Provider Demographics
NPI:1003378266
Name:DEMING-COMBS, JOAN PATRICIA
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:PATRICIA
Last Name:DEMING-COMBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 HIGH MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-5932
Mailing Address - Country:US
Mailing Address - Phone:325-212-4742
Mailing Address - Fax:
Practice Address - Street 1:3821 HIGH MEADOW DR
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-5932
Practice Address - Country:US
Practice Address - Phone:325-212-4742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional