Individual
ANDREW DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1704 W KOENIG LN, AUSTIN, TX 78756-1207
(307) 287-2639
Mailing address
1704 W KOENIG LN, AUSTIN, TX 78756-1207
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
66567
LMSW
TX
Enumeration date
01/16/2019
Last updated
01/16/2019
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