Provider Demographics
NPI:1487280053
Name:DAVILA, VICTORIA (LMHC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:DAVILA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10410 NW 7TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1019
Mailing Address - Country:US
Mailing Address - Phone:786-427-3880
Mailing Address - Fax:
Practice Address - Street 1:3000 NW 101ST LN # 201
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3930
Practice Address - Country:US
Practice Address - Phone:954-272-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health