| Doctor Name: | MS. CONNIE MARIE DAVIS |
| NPI Number: | 1821054370 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS PSYCHOLOGIST |
| License Number: | PS005757L |
| Business Practice Address: | 105 Lakeview Road Mt Gretna, PA - 17064 |
| Business Phone Number: | 7179643850 |
| Business Fax Number: | 7179643850 |
| Mailing Address: | Box 122 105 Lakeview Road, MT GRETNA |
| State: | PA |
| Postal Code: | 17064 |
| Phone Number: | 7179643850 |
| Fax Number: | 7179643850 |
| NPI Enumeration Date: | 04/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS005757L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |