Individual
SAMANTHA ANN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 SHADOW LN, AZLE, TX 76020-2028
(817) 300-5622
Mailing address
116 SHADOW LN, AZLE, TX 76020-2028
(817) 300-5622
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/19/2024
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