Healthcare Provider Details

I. General information

NPI: 1124637632
Provider Name (Legal Business Name): VERONICA LLANOS-DAVIS MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 SAN PEDRO AVE
SAN ANTONIO TX
78212-3603
US

IV. Provider business mailing address

2610 INDIAN FRST
SAN ANTONIO TX
78244-4403
US

V. Phone/Fax

Practice location:
  • Phone: 210-288-2650
  • Fax:
Mailing address:
  • Phone: 210-288-2650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number202952
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: