Doctor Name: | MS. ATHENA J. DAVIS |
NPI Number: | 1326306911 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.C. |
License Number: | 0701004318 |
Business Practice Address: | 5412 Glenside Dr Ste F Henrico, VA - 232283995 |
Business Phone Number: | 8042825880 |
Business Fax Number: | 8042882029 |
Mailing Address: | 5412 Glenside Dr Ste F, HENRICO |
State: | VA |
Postal Code: | 232283995 |
Phone Number: | 8042825880 |
Fax Number: | 8042882029 |
NPI Enumeration Date: | 05/02/2012 |
NPI Last Update Date: | 05/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701004318 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |