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General NPI Number Information
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NPI Number | 1578000683
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Entity Type | Organization
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Legal Business Name | JOANNA R. DAVIS, LMHC CAP
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 124 E MIRACLE STRIP PKWY SUITE 602
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City | MARY ESTHER
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State | FL
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Zip | 32569-1988
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Country | US
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Telephone | 850-243-7035
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 879
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City | FORT WALTON BEACH
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State | FL
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Zip | 32549-0879
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INSURANCE SPECIALIST/ASST. MANAGER
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Name | MARIA TUMANENG
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Credential |
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Telephone | 850-243-7035
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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 | MH10454
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License Number State | FL
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