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General NPI Number Information
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NPI Number | 1700641289
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Entity Type | Individual
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Provider Name | SECARRA DAVIDA WALTON
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Gender | Female
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Dates
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Enumeration Date | 02/14/2024
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 19702 NARVI CT
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City | SPRING
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State | TX
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Zip | 77379-1475
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Country | US
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Telephone | 832-409-4417
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Fax | 833-320-8545
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Provider Business Mailing Address
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Address Line | 4823 FOREST HURST GLN
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City | SPRING
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State | TX
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Zip | 77373-2401
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Country | US
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Telephone | 951-662-3543
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 88834
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License Number State | TX
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