| NPI | 1588715486 |
|---|---|
| Other Name | MIKE DAVIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 06-07P) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AR 06-07P) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2023-05-10 |