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Individual

DR. THOMAS DAVISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
8873 QUIMPER PL, SHREVEPORT, LA 71105-5620
(318) 686-0012
(318) 686-0012
Mailing address
8873 QUIMPER PL, SHREVEPORT, LA 71105-5620
(318) 686-0012
(318) 686-0012

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0082561
NM
101YP2500X
Professional Counselor
0158731
NM
101YP2500X
Professional Counselor
Primary
5752
LA

Other

Enumeration date
04/22/2013
Last updated
10/10/2013
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