Provider Demographics
NPI:1477194686
Name:DAVIS, KIMBERLY SIENNA (LPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SIENNA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12345 JONES RD STE 287-14
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4960
Mailing Address - Country:US
Mailing Address - Phone:281-215-3625
Mailing Address - Fax:833-302-0272
Practice Address - Street 1:12345 JONES RD STE 287-14
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4960
Practice Address - Country:US
Practice Address - Phone:281-215-3625
Practice Address - Fax:833-302-0272
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional