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NPI Code Detail

MEDICARE: MELISSA WATSON DAVIS MA

MEDICARE: MELISSA WATSON DAVIS MA
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 Counselor21055SD

General Provider Information

NPI Number : 1881415479
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA WATSON DAVIS MA
Provider Business Mailing Address
First Line : 909 SAINT JOSEPH ST STE 201
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-3304
Country : US
Telephone Number : 605-299-9100
Fax Number : 605-299-9100
Provider Business Practice Location Address
First Line : 909 SAINT JOSEPH ST STE 201
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-3304
Country : US
Telephone Number : 605-299-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2024
Last Update Date : 10/17/2024

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Directions to “ MELISSA WATSON DAVIS MA” Practice Location

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