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NPI Code Detail

MEDICARE: IYANNA DESIREE DAVIS

MEDICARE: IYANNA DESIREE DAVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorP137766NY

General Provider Information

NPI Number : 1104758275
Entity Type Code : Individual
Provider Name (Legal Business Name) : IYANNA DESIREE DAVIS
Provider Business Mailing Address
First Line : 317 WEST AVE
Second Line :
City : ALBION
State : NY
Zip : 14411-1522
Country : US
Telephone Number : 585-589-5613
Fax Number :
Provider Business Practice Location Address
First Line : 317 WEST AVE
Second Line :
City : ALBION
State : NY
Zip : 14411-1522
Country : US
Telephone Number : 585-589-5613
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “ IYANNA DESIREE DAVIS ” Practice Location

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