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NPI Code Detail

MEDICARE: CHARMAI MARILYN DAVALOS

MEDICARE:   CHARMAI MARILYN DAVALOS
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
1106H00000XMarriage & Family Therapist2232TN

General Provider Information

NPI Number : 1801660576
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARMAI MARILYN DAVALOS
Provider Business Mailing Address
First Line : 2024 EXETER RD STE 1
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-3933
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2024 EXETER RD STE 1
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-3933
Country : US
Telephone Number : 901-310-5014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2023
Last Update Date : 11/13/2023

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Directions to “ CHARMAI MARILYN DAVALOS ” Practice Location

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