Provider Demographics
NPI:1689881013
Name:LAMUN, MARY LEE (MED,LPC,LMFT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:LEE
Last Name:LAMUN
Suffix:
Gender:F
Credentials:MED,LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 SAGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-3735
Mailing Address - Country:US
Mailing Address - Phone:817-613-0649
Mailing Address - Fax:817-613-0649
Practice Address - Street 1:2105 SAGEWOOD DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-3735
Practice Address - Country:US
Practice Address - Phone:817-613-0649
Practice Address - Fax:817-613-0649
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9856101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health