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NPI Code Detail

MEDICARE: NATASHA DAVIDSON LLMSW

MEDICARE: NATASHA DAVIDSON LLMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor6801100067MI
2320800000XMental Illness Community Based Residential Treatment Facility6801100067MI

General Provider Information

NPI Number : 1043763675
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA DAVIDSON LLMSW
Provider Business Mailing Address
First Line : 2004 FOX HILL DR
Second Line : APT 7
City : GRAND BLANC
State : MI
Zip : 48439-5244
Country : US
Telephone Number : 810-969-4561
Fax Number : 810-969-4563
Provider Business Practice Location Address
First Line : 5699 GENESEE RD
Second Line : LAPEER, MI
City : LAPEER
State : MI
Zip : 48446-2749
Country : US
Telephone Number : 810-969-4561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2016
Last Update Date : 08/01/2016

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Directions to “ NATASHA DAVIDSON LLMSW” Practice Location

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