NPI | 1417211269 |
---|---|
Other Name | LESTINE T DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 65349) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX Grades EC-12) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 6979) | |
Enumeration Date | 2012-06-26 |
Last Update Date | 2014-12-09 |