Doctor Name: | DR. JAMES PETER DAVIG |
NPI Number: | 1255383824 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D., LP |
License Number: | LP4334 |
Business Practice Address: | 2835 S Service Dr Suite 203 Red Wing, MN - 550661882 |
Business Phone Number: | 6513880052 |
Business Fax Number: | 6513880054 |
Mailing Address: | 2835 S Service Dr, Suite 203 RED WING |
State: | MN |
Postal Code: | 550661882 |
Phone Number: | 6513880052 |
Fax Number: | 6513880054 |
NPI Enumeration Date: | 05/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TB0200X |
License Number: | LP4334 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Cognitive & Behavioral |
Taxonomy Definition: |