Provider Demographics
NPI:1356673990
Name:THURMOND, LATRANDA W (LCDC)
Entity type:Individual
Prefix:MRS
First Name:LATRANDA
Middle Name:W
Last Name:THURMOND
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10714 SILKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-1111
Mailing Address - Country:US
Mailing Address - Phone:832-309-3336
Mailing Address - Fax:
Practice Address - Street 1:10714 SILKWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSOTN
Practice Address - State:TX
Practice Address - Zip Code:77031
Practice Address - Country:US
Practice Address - Phone:832-309-3336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9742101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)