Doctor Name: | STEPHEN E DAVIS |
NPI Number: | 1366671166 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 295 Hospital St Moulton, AL - 356501210 |
Business Phone Number: | 2563556105 |
Business Fax Number: | |
Mailing Address: | 1316 Somerville Rd Se, Suite 1 DECATUR |
State: | AL |
Postal Code: | 356014305 |
Phone Number: | 2563556105 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2009 |
NPI Last Update Date: | 07/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |