| Doctor Name: | MARY BETH DAVIS |
| NPI Number: | 1134138712 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149-002443 |
| Business Practice Address: | 1301 Pyott Rd Suite201e Lake In The Hills, IL - 601569794 |
| Business Phone Number: | 8478401600 |
| Business Fax Number: | |
| Mailing Address: | 1301 Pyott Rd, Ste 201 E LAKE IN THE HILLS |
| State: | IL |
| Postal Code: | 601569794 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/05/2006 |
| NPI Last Update Date: | 07/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149-002443 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |