Provider Demographics
NPI:1801560065
Name:DAVILA V., ADRIANA (MA, ALMFT)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:DAVILA V.
Suffix:
Gender:F
Credentials:MA, ALMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S WHEATON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5207
Mailing Address - Country:US
Mailing Address - Phone:630-447-0384
Mailing Address - Fax:
Practice Address - Street 1:213 S WHEATON AVE STE 101
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5207
Practice Address - Country:US
Practice Address - Phone:630-447-0384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000911106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist