| NPI | 1487050571 |
|---|---|
| Former Legal Business Name | REVEREND CARROL DAVIS |
| Entity Type | Organization |
| Authorized Contact | PHYLLIS JANE ERICSON-DAVIS Clinical Psychologist, Rev. 864-449-4867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable (Licence: WA #75132117) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-24 |