Healthcare Provider Details

I. General information

NPI: 1881488542
Provider Name (Legal Business Name): HOLLY A DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 JAKE ALEXANDER BLVD W
SALISBURY NC
28147-1213
US

IV. Provider business mailing address

2109 HAMBLIN RD
KANNAPOLIS NC
28083-8711
US

V. Phone/Fax

Practice location:
  • Phone: 704-645-8539
  • Fax:
Mailing address:
  • Phone: 919-805-4213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: