Provider Demographics
NPI:1558540120
Name:DEBONA, ANTHONY DOMINIC (LMSW)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:DOMINIC
Last Name:DEBONA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 E AIRLINE RD
Mailing Address - Street 2:SUITE 40
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4112
Mailing Address - Country:US
Mailing Address - Phone:361-582-7708
Mailing Address - Fax:361-582-7701
Practice Address - Street 1:1502 E AIRLINE RD
Practice Address - Street 2:SUITE 40
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4112
Practice Address - Country:US
Practice Address - Phone:361-582-7708
Practice Address - Fax:361-582-7701
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX395081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical