Provider Demographics
NPI:1174130272
Name:DEBONA, DIANNA G
Entity type:Individual
Prefix:MS
First Name:DIANNA
Middle Name:G
Last Name:DEBONA
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 1:5564 HIGHWAY 115
Mailing Address - Street 2:
Mailing Address - City:SAINT LANDRY
Mailing Address - State:LA
Mailing Address - Zip Code:71367-3306
Mailing Address - Country:US
Mailing Address - Phone:318-838-4167
Mailing Address - Fax:
Practice Address - Street 1:5564 HIGHWAY 115
Practice Address - Street 2:
Practice Address - City:SAINT LANDRY
Practice Address - State:LA
Practice Address - Zip Code:71367-3306
Practice Address - Country:US
Practice Address - Phone:318-838-4167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator