| Lisa M. Davis, Llc | |
|
351 6th Ave W Bradenton FL 34205-8820 | |
| (941) 737-8897 | |
| Not Available |
| Full Name | Lisa M. Davis, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 351 6th Ave W, Bradenton, Florida |
| Authorized Official Name and Position | Lisa M Davis (MANAGING MEMBER) |
| Authorized Official Contact | 9417378897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M. Davis, Llc 351 6th Ave W Bradenton FL 34205-8820 Ph: (941) 737-8897 | Lisa M. Davis, Llc 351 6th Ave W Bradenton FL 34205-8820 Ph: (941) 737-8897 |
| NPI Number | 1972054476 |
|---|---|
| Provider Enumeration Date | 10/19/2016 |
| Last Update Date | 10/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972054476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH4468 (Florida) | Primary |
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