| Doctor Name: | ROXANNA LEE FORDON |
| NPI Number: | 1043269087 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 17372 |
| Business Practice Address: | 1521 Green Oak Pl #208 Humble, TX - 773392057 |
| Business Phone Number: | 2818128489 |
| Business Fax Number: | 2813587788 |
| Mailing Address: | 1521 Green Oak Pl, #208 HUMBLE |
| State: | TX |
| Postal Code: | 773392057 |
| Phone Number: | 2818128489 |
| Fax Number: | 2813587788 |
| NPI Enumeration Date: | 05/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 17372 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |