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NPI Code Detail

MEDICARE: CHRISTAL DAVIS PHD

MEDICARE: CHRISTAL DAVIS PHD
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
1103T00000XPsychologistPS020679PA

General Provider Information

NPI Number : 1790630846
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTAL DAVIS PHD
Provider Business Mailing Address
First Line : 2200 BENJAMIN FRANKLIN PKWY APT E1712
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-3768
Country : US
Telephone Number : 662-816-1919
Fax Number :
Provider Business Practice Location Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-746-0465
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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