Provider Information for 1003360256
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PAULA DAVIS Ed.S, LPC, NCC, NCSC
Sex: Female
NPI: 1003360256
Last Updated: 2023-06-23
Certification Date: 2023-06-23
Certification Date: 2023-06-23
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1003360256 | ||||||||||||
| Enumeration Date | 2016-08-04 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 72 NORTHWOOD DR WAYNESBORO, MS 39367-9045 United States Phone: 601-410-7771 | Fax:601-735-0823 | ||||||||||||
| Primary Practice Address | 72 NORTHWOOD DR WAYNESBORO, MS 39367-9045 United States Phone: 601-410-7771 | Fax:601-735-4195 | ||||||||||||
| Secondary Practice Address(es) | 72 NORTHWOOD DR | ||||||||||||
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