Provider Demographics
NPI:1689914616
Name:DAVIS, SANDRA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 S CUSTER RD STE 803
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-1453
Mailing Address - Country:US
Mailing Address - Phone:469-406-6899
Mailing Address - Fax:469-625-2218
Practice Address - Street 1:1402 S CUSTER RD STE 803
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-1453
Practice Address - Country:US
Practice Address - Phone:469-406-6899
Practice Address - Fax:469-625-2218
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35019103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical