MEDICARE: ZAHRA MICHELLE AMBER DAVIS-DIALLO LGPC

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
1	101YM0800X	Mental Health Counselor	LGP15265	MD

General Provider Information

NPI Number	:	1134950728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAHRA MICHELLE AMBER DAVIS-DIALLO LGPC

Provider Business Mailing Address
First Line	:	6641 WAYNE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-3519
Country	:	US
Telephone Number	:	267-370-4283
Fax Number	:

Provider Business Practice Location Address
First Line	:	9750 APOLLO DR # B29
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-4924
Country	:	US
Telephone Number	:	240-795-2883
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2024
Last Update Date	:	04/07/2026

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