Provider Demographics
NPI:1205479615
Name:DAVIS, DONNA MARIE
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCI
Mailing Address - Street 1:10223 BROADWAY ST STE P411
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7880
Mailing Address - Country:US
Mailing Address - Phone:832-444-7605
Mailing Address - Fax:
Practice Address - Street 1:10223 BROADWAY ST STE P411
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7880
Practice Address - Country:US
Practice Address - Phone:832-444-7605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79883101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional