Provider Demographics
NPI:1568773539
Name:DILLON, GREGORY LAMON (EDD, LPC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:LAMON
Last Name:DILLON
Suffix:
Gender:M
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 742
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77516-0742
Mailing Address - Country:US
Mailing Address - Phone:832-228-4450
Mailing Address - Fax:
Practice Address - Street 1:2315 E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3804
Practice Address - Country:US
Practice Address - Phone:832-228-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66577101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional