Provider Demographics
NPI:1487832689
Name:LONNIE DEGGINS
Entity Type:Organization
Organization Name:LONNIE DEGGINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:281-964-7269
Mailing Address - Street 1:1442 KINGWOOD DR # 103
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3040
Mailing Address - Country:US
Mailing Address - Phone:281-964-7269
Mailing Address - Fax:832-415-2681
Practice Address - Street 1:1442 KINGWOOD DR # 103
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3040
Practice Address - Country:US
Practice Address - Phone:281-964-7269
Practice Address - Fax:832-415-2681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty