=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073689816
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DONNA F DAVIES, PSY.D., PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/24/2006
-----------------------------------------------------
Last Update Date | 01/10/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9112 GRIFFIN RD SUITE D
-----------------------------------------------------
City | COOPER CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33328-3540
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-252-1274
-----------------------------------------------------
Fax | 954-252-6167
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9112 GRIFFIN RD SUITE D
-----------------------------------------------------
City | COOPER CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33328-3540
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-252-1274
-----------------------------------------------------
Fax | 954-252-6167
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. DONNA FELECIA DAVIES
-----------------------------------------------------
Credential | PSY.D.
-----------------------------------------------------
Telephone | 954-252-1274
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | PY0004701
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------