Individual
MIA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5903 GRACE LN, HOUSTON, TX 77021-3424
(713) 307-0208
Mailing address
5903 GRACE LN, HOUSTON, TX 77021-3424
(713) 397-0208
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
TX
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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