| Doctor Name: | MS. MARCIA COLANTHA DAVIS |
| NPI Number: | 1154674943 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 6401004729 |
| Business Practice Address: | 37510 Jefferson Ave Unit 102 Harrison Township, MI - 480452671 |
| Business Phone Number: | 5864685712 |
| Business Fax Number: | |
| Mailing Address: | 37510 Jefferson Ave, Unit 102 HARRISON TOWNSHIP |
| State: | MI |
| Postal Code: | 480452671 |
| Phone Number: | 5864685712 |
| Fax Number: | |
| NPI Enumeration Date: | 10/18/2012 |
| NPI Last Update Date: | 10/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 6401004729 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |