Individual
DR. JONATHAN RAY SQUYRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
130 MICHAELS LOOP, LUFKIN, TX 75901-8317
(936) 824-5011
Mailing address
130 MICHAELS LOOP, LUFKIN, TX 75901-8317
(936) 824-5011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
18907
TX
103T00000X
Psychologist
Primary
38103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174531702
—
TX
Enumeration date
09/16/2005
Last updated
10/11/2019
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