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General NPI Number Information
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NPI Number | 1861160004
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Entity Type | Individual
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Provider Name | ERIC DAVIS
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Gender | Male
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 122 NH ROUTE 12-A
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City | LANGDON
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State | NH
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Zip | 03602-0720
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Country | US
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Telephone | 603-855-0006
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Fax |
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Provider Business Mailing Address
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Address Line | 5 COLONIAL VILLAGE DR APT 8
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City | NORTH SWANZEY
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State | NH
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Zip | 03431-4525
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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 |
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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