| Doctor Name: | TARA B DAVIS |
| NPI Number: | 1013290923 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | PC006036 |
| Business Practice Address: | 101 E 6th St Erie, PA - 165011201 |
| Business Phone Number: | 8144592755 |
| Business Fax Number: | 8144564873 |
| Mailing Address: | 101 E 6th St, Po Box 1506 ERIE |
| State: | PA |
| Postal Code: | 165011201 |
| Phone Number: | 8144592755 |
| Fax Number: | 8144564873 |
| NPI Enumeration Date: | 09/27/2011 |
| NPI Last Update Date: | 09/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC006036 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |