Provider Demographics
NPI:1598236960
Name:LEMOS, DELMA (LCDC, CART)
Entity Type:Individual
Prefix:
First Name:DELMA
Middle Name:
Last Name:LEMOS
Suffix:
Gender:F
Credentials:LCDC, CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 LATTA ST APT 1021
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-7581
Mailing Address - Country:US
Mailing Address - Phone:432-701-1932
Mailing Address - Fax:
Practice Address - Street 1:1301 LATTA ST APT 1021
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-7581
Practice Address - Country:US
Practice Address - Phone:432-203-7548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13544101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)