Provider Demographics
NPI:1013589878
Name:WILLS, DEANN MARIE (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:DEANN
Middle Name:MARIE
Last Name:WILLS
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 NALL ST
Mailing Address - Street 2:
Mailing Address - City:PORT NECHES
Mailing Address - State:TX
Mailing Address - Zip Code:77651-3714
Mailing Address - Country:US
Mailing Address - Phone:409-540-2055
Mailing Address - Fax:
Practice Address - Street 1:2054 NALL ST
Practice Address - Street 2:
Practice Address - City:PORT NECHES
Practice Address - State:TX
Practice Address - Zip Code:77651-3714
Practice Address - Country:US
Practice Address - Phone:406-540-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83070101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional