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General NPI Number Information
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NPI Number | 1386391415
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Entity Type | Individual
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Provider Name | CARLA DAVIS-MANN
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Gender | Female
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 200 BANNING ST
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City | DOVER
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State | DE
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Zip | 19904-3485
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Country | US
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Telephone | 302-258-8218
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Fax |
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Provider Business Mailing Address
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Address Line | 4223 STEIN HWY
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City | SEAFORD
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State | DE
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Zip | 19973-6754
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Country | US
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Telephone | 302-258-8218
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | Q3-0010616
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License Number State | DE
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