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General NPI Number Information
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NPI Number | 1255785416
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Entity Type | Individual
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Provider Name | DONNA DENISE DAVIS LPC
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Gender | Female
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 16250 NORTHLAND DR STE 238
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5227
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Country | US
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Telephone | 313-613-8027
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Fax | 313-659-0477
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Provider Business Mailing Address
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Address Line | 9597 ARTESIAN ST
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City | DETROIT
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State | MI
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Zip | 48228-1335
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Country | US
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Telephone | 313-613-8027
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Fax | 313-659-0477
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401017717
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License Number State | MI
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