Provider Demographics
NPI:1063980878
Name:EDMONDSON-DAVIS, RASHIDA Z (MA)
Entity type:Individual
Prefix:MRS
First Name:RASHIDA
Middle Name:Z
Last Name:EDMONDSON-DAVIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 LAUREL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-3604
Mailing Address - Country:US
Mailing Address - Phone:347-585-9768
Mailing Address - Fax:
Practice Address - Street 1:14275 MIDWAY RD STE 260
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3613
Practice Address - Country:US
Practice Address - Phone:347-585-9768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-09
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician