Healthcare Provider Details

I. General information

NPI: 1972832236
Provider Name (Legal Business Name): EMILY A DAVIS PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 12/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 PLEASANT AVENUE
HAMILTON OH
45015
US

IV. Provider business mailing address

2100 PLEASANT AVENUE
HAMILTON OH
45015
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-1562
  • Fax: 513-868-1415
Mailing address:
  • Phone: 513-868-1562
  • Fax: 513-868-1415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6191
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: