Provider Demographics
NPI:1548021736
Name:DEGUERRA, ANGELA MARIA (LPC-A)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
Last Name:DEGUERRA
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8118 BLUE JAY ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77523-0802
Mailing Address - Country:US
Mailing Address - Phone:281-684-6596
Mailing Address - Fax:
Practice Address - Street 1:5010 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9606
Practice Address - Country:US
Practice Address - Phone:281-421-0090
Practice Address - Fax:281-421-0193
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional