| Doctor Name: | DR. PAUL A DAVIS |
| NPI Number: | 1619995297 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD, LP |
| License Number: | 355 |
| Business Practice Address: | 49725 County 83 Staples, MN - 564795280 |
| Business Phone Number: | 2188941515 |
| Business Fax Number: | 2188941316 |
| Mailing Address: | 49725 County 83, STAPLES |
| State: | MN |
| Postal Code: | 564795280 |
| Phone Number: | 2188941515 |
| Fax Number: | 2188941316 |
| NPI Enumeration Date: | 07/18/2006 |
| NPI Last Update Date: | 01/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 355 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ND |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |