Healthcare Provider Details

I. General information

NPI: 1073689816
Provider Name (Legal Business Name): DONNA F DAVIES, PSY.D., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9112 GRIFFIN RD SUITE D
COOPER CITY FL
33328-3540
US

IV. Provider business mailing address

9112 GRIFFIN RD SUITE D
COOPER CITY FL
33328-3540
US

V. Phone/Fax

Practice location:
  • Phone: 954-252-1274
  • Fax: 954-252-6167
Mailing address:
  • Phone: 954-252-1274
  • Fax: 954-252-6167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY0004701
License Number StateFL

VIII. Authorized Official

Name: DR. DONNA FELECIA DAVIES
Title or Position: OWNER
Credential: PSY.D.
Phone: 954-252-1274