Provider Demographics
NPI:1437407434
Name:DESIMONE-PORTER, DEBRA A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:A
Last Name:DESIMONE-PORTER
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 1:2432 CENTAURUS DR STE 600
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-6644
Mailing Address - Country:US
Mailing Address - Phone:361-688-4464
Mailing Address - Fax:
Practice Address - Street 1:2432 CENTAURUS DR STE 600
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-6644
Practice Address - Country:US
Practice Address - Phone:361-688-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-22
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68158101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor