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General NPI Number Information
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NPI Number | 1669593182
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Entity Type | Individual
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Provider Name | MARY CAROLE DAVIS'LIBRE LPC
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 3500 VIRGINIA BEACH BLVD SUITE 210 MARY C. DAVIS'LIBRE, LPC
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4445
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Country | US
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Telephone | 757-376-7121
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Fax | 757-416-5236
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Provider Business Mailing Address
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Address Line | 3500 VIRGINIA BEACH BLVD SUITE 210 MARY C. DAVIS'LIBRE, LPC
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4445
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Country | US
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Telephone | 757-376-7121
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Fax | 757-416-5236
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0701003407
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License Number State | VA
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