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General NPI Number Information
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NPI Number | 1477394138
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Entity Type | Organization
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Legal Business Name | ELIZABETH DAVIS PHD LLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 499 CENTURY LN
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City | HOLLAND
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State | MI
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Zip | 49423-4393
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Country | US
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Telephone | 203-244-7644
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Fax |
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Provider Business Mailing Address
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Address Line | 91 MOSSY COVE LN
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City | HOLLAND
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State | MI
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Zip | 49424-2577
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Country | US
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Telephone | 617-852-5106
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Fax |
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Authorized Official
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Title or Position | OWNER, PSYCHOLOGIST
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Name | DR. ELIZABETH CHARLOTTE DAVIS
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Credential | PH.D.
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Telephone | 203-244-7644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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