Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 225XM0800X | Mental Health |
NPI | 1083128904 |
---|---|
Provider Name | Mr. Roscoe Deondre Lawton |
First Address | Katy, TX 77449-4594 |
Second Address | Katy, TX 77449-4594 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2017 |
Last Update Date | 30/11/2017 |