Individual
AMANDA JEANNE DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23 DUNCAN ST, GLOUCESTER, MA 01930-6001
(781) 990-9090
Mailing address
23 DUNCAN ST, GLOUCESTER, MA 01930-6001
(781) 990-9090
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
04/02/2019
Last updated
04/02/2019
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