Provider Demographics
NPI:1225647134
Name:DEEMER, MEREDITH ARNOLD
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ARNOLD
Last Name:DEEMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ARNOLD
Other - Last Name:DEEMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MANKOWSKI, RABON
Mailing Address - Street 1:1410 SPANISH TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-2708
Mailing Address - Country:US
Mailing Address - Phone:817-894-1371
Mailing Address - Fax:
Practice Address - Street 1:320 WESTWAY PL STE 530
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1000
Practice Address - Country:US
Practice Address - Phone:817-894-1371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health