Provider Demographics
NPI:1184661068
Name:THUESON, ROGANNE KISER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROGANNE
Middle Name:KISER
Last Name:THUESON
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 1:16507 WHITAKER CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095
Mailing Address - Country:US
Mailing Address - Phone:979-255-1065
Mailing Address - Fax:281-855-0556
Practice Address - Street 1:16507 WHITAKER CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095
Practice Address - Country:US
Practice Address - Phone:979-255-1065
Practice Address - Fax:281-855-0556
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780249-01Medicaid