Individual
MARTHA ANN DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA,LPC
Contact information
Practice address
2301 MIDWESTERN PKWY. STE. 212, WICHITA FALLS, TX 76308-2335
(940) 696-0181
(940) 696-5692
Mailing address
2301 MIDWESTERN PKWY. STE. 212, WICHITA FALLS, TX 76308-2335
(940) 696-0181
(940) 696-5692
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC17076
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5071LC
BCBS PROVIDER ID
TX
01
—
LPC17076
TEXAS STATE LICENSE
TX
Enumeration date
09/14/2005
Last updated
07/08/2007
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