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Individual
MICHAEL WAYNE DAVIS
Active
Individual
MICHAEL WAYNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005678
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
324461
VALUE OPTIONS
VA
01
—
342707
ANTHEM
VA
01
—
4945131
VIRGINIA PREMIER
VA
05
—
4945131
—
VA
01
—
O803365M
SENTARA
VA
Enumeration date
11/14/2007
Last updated
07/25/2008
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