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General NPI Number Information
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NPI Number | 1154857720
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Entity Type | Individual
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Provider Name | REBECCA I DAVIS MA
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Gender | Female
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Dates
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Enumeration Date | 05/02/2017
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Last Update Date | 12/06/2022
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Provider Practice Location Address
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Address Line | 54 HARRIS PL
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7127
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Country | US
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Telephone | 802-258-0970
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Fax |
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Provider Business Mailing Address
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Address Line | 92 WARDON RD
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City | PUTNEY
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State | VT
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Zip | 05346-8980
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Country | US
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Telephone | 802-387-2757
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 097.0129615
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 068.0134940
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License Number State | VT
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