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General NPI Number Information
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NPI Number | 1346733631
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Entity Type | Individual
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Provider Name | RENEE DAVIS
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 920 MORNINGDALE DR
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City | WILMINGTON
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State | DE
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Zip | 19810-1458
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Country | US
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Telephone | 302-898-1720
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Fax |
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Provider Business Mailing Address
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Address Line | 920 MORNINGDALE DR
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City | WILMINGTON
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State | DE
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Zip | 19810-1458
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Country | US
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Telephone | 302-898-1720
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 06141
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License Number State | MD
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