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Organization
SOUTHLAKE CHILD AND FAMILY THERAPY
Active
Organization
SOUTHLAKE CHILD AND FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHARINE ANNE OTTONE DAVIS PHD, LPC (OWNER)
(817) 266-8676
Entity
Organization
Contact information
Practice address
2141 KIRKWOOD BLVD STE 130, SOUTHLAKE, TX 76092-1464
(817) 266-8676
Mailing address
1933 BERKELEY PL, FORT WORTH, TX 76110-1209
(817) 266-8676
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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