Provider Demographics
NPI:1841857372
Name:PROULX, DONNA MAY
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MAY
Last Name:PROULX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 GUMSPRING LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-6329
Mailing Address - Country:US
Mailing Address - Phone:281-701-8088
Mailing Address - Fax:
Practice Address - Street 1:2307 GUMSPRING LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-6329
Practice Address - Country:US
Practice Address - Phone:281-701-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67031101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional