Individual
EDEN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LPC
Contact information
Practice address
204 FRONT STREET, QUANAH, TX 79252
(254) 315-4829
Mailing address
204 FRONT STREET, QUANAH, TX 79252
(254) 315-4829
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
73850
TX
103K00000X
Behavior Analyst
1-16-24503
TX
Other
Enumeration date
01/11/2017
Last updated
05/18/2020
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