Provider Demographics
NPI:1508010059
Name:MCDONALD, DEBRA WINTER (RN,LPC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:WINTER
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RN,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 SAN CHEZ DR
Mailing Address - Street 2:
Mailing Address - City:LAKE KIOWA
Mailing Address - State:TX
Mailing Address - Zip Code:76240-8802
Mailing Address - Country:US
Mailing Address - Phone:281-687-1452
Mailing Address - Fax:713-839-9471
Practice Address - Street 1:113 SAN CHEZ DR
Practice Address - Street 2:
Practice Address - City:LAKE KIOWA
Practice Address - State:TX
Practice Address - Zip Code:76240-8802
Practice Address - Country:US
Practice Address - Phone:281-687-1452
Practice Address - Fax:713-839-9471
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13694101YP2500X
TX237596163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation