Healthcare Provider Details

I. General information

NPI: 1487585923
Provider Name (Legal Business Name): OLIVIA DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 ABBOTT RD
ANCHORAGE AK
99507-4314
US

IV. Provider business mailing address

PO BOX 2443
SOLDOTNA AK
99669-2443
US

V. Phone/Fax

Practice location:
  • Phone: 907-346-2101
  • Fax:
Mailing address:
  • Phone: 907-953-8068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: