Provider Demographics
NPI:1124637632
Name:LLANOS-DAVIS, VERONICA (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:LLANOS-DAVIS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 INDIAN FRST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-4403
Mailing Address - Country:US
Mailing Address - Phone:210-288-2650
Mailing Address - Fax:
Practice Address - Street 1:1818 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-3603
Practice Address - Country:US
Practice Address - Phone:210-288-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202952106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist