| Doctor Name: | MARTHA ANN DAVIS |
| NPI Number: | 1558776104 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LLPC |
| License Number: | 6401014279 |
| Business Practice Address: | 117 W Genesee St Suite 9 Iron River, MI - 499351497 |
| Business Phone Number: | 9062652000 |
| Business Fax Number: | 9062652004 |
| Mailing Address: | 117 W Genesee St, Suite 9 IRON RIVER |
| State: | MI |
| Postal Code: | 499351497 |
| Phone Number: | 9062652000 |
| Fax Number: | 9062652004 |
| NPI Enumeration Date: | 06/23/2014 |
| NPI Last Update Date: | 06/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401014279 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |