Doctor Name: | DR. ROGER R DAVIES |
NPI Number: | 1194785865 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | SCD. |
License Number: | 3306 |
Business Practice Address: | 1 W Foster St Suite 10 Melrose, MA - 021763810 |
Business Phone Number: | 6173069095 |
Business Fax Number: | 3392934299 |
Mailing Address: | 1 W Foster St, Suite 10 MELROSE |
State: | MA |
Postal Code: | 021763810 |
Phone Number: | 7813069095 |
Fax Number: | 3392934299 |
NPI Enumeration Date: | 03/25/2006 |
NPI Last Update Date: | 11/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 3306 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |