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Individual
SUSAN MARIE DAVIS
Active
Individual
SUSAN MARIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6512
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131558
UCARE
MN
01
—
5G670DA
BCBS
MN
01
—
62-78790
MEDICA
MN
01
—
HP40253
HEALTH PARTNERS
MN
Enumeration date
10/13/2006
Last updated
07/09/2007
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