Provider Demographics
NPI:1386225795
Name:BAGGERMAN, LORA S (LPC)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:S
Last Name:BAGGERMAN
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 1:7239 BOYDSTON RD
Mailing Address - Street 2:
Mailing Address - City:GROOM
Mailing Address - State:TX
Mailing Address - Zip Code:79039-4905
Mailing Address - Country:US
Mailing Address - Phone:806-662-2611
Mailing Address - Fax:
Practice Address - Street 1:7239 BOYDSTON RD
Practice Address - Street 2:
Practice Address - City:GROOM
Practice Address - State:TX
Practice Address - Zip Code:79039-4905
Practice Address - Country:US
Practice Address - Phone:806-662-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73828101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health