Provider Demographics
NPI:1063252559
Name:DEVARONA, CATALINA R
Entity type:Individual
Prefix:
First Name:CATALINA
Middle Name:R
Last Name:DEVARONA
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 1:3100 S W S YOUNG DR # PO10425
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-2001
Mailing Address - Country:US
Mailing Address - Phone:254-247-8955
Mailing Address - Fax:
Practice Address - Street 1:5969 SHANNON LN
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-4835
Practice Address - Country:US
Practice Address - Phone:254-247-8955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94702101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health