Healthcare Provider Details

I. General information

NPI: 1770765349
Provider Name (Legal Business Name): DAVIN E MAGNO M.ED, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 N ZARAGOZA RD STE A11
EL PASO TX
79936-7893
US

IV. Provider business mailing address

616 N VIRGINIA ST STE F
EL PASO TX
79902-5311
US

V. Phone/Fax

Practice location:
  • Phone: 915-544-3500
  • Fax: 915-544-3503
Mailing address:
  • Phone: 915-544-3500
  • Fax: 915-544-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17147
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: