Provider Demographics
NPI:1174948533
Name:DAVILA O'TOOLE, LISA (MS, LPC, LMFT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DAVILA O'TOOLE
Suffix:
Gender:F
Credentials:MS, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1252
Mailing Address - Country:US
Mailing Address - Phone:281-620-6924
Mailing Address - Fax:
Practice Address - Street 1:402 JULIE RIVERS DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3144
Practice Address - Country:US
Practice Address - Phone:281-277-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15872101YP2500X
TX4955106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist