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General NPI Number Information
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NPI Number | 1548686322
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Entity Type | Organization
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Legal Business Name | DAVIS GROUP LLC
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 30 GRAND AVE
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City | NEW HAVEN
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State | CT
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Zip | 06513
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Country | US
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Telephone | 203-627-8734
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Fax | 203-889-2871
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Provider Business Mailing Address
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Address Line | PO BOX 240
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City | NEW HAVEN
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State | CT
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Zip | 06513-0240
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Country | US
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Telephone | 203-627-8734
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MS. LAMAARA DAVIS
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Credential |
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Telephone | 203-627-8734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 007108
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 005782
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License Number State | CT
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