Individual
MRS. EDWINA ANNETTE DAVIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 LOUDOUN RD, INDIAN TRAIL, NC 28079-8478
(310) 762-2372
Mailing address
1000 LOUDOUN RD, INDIAN TRAIL, NC 28079-8478
(310) 762-2372
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
101073854
CA
174400000X
Specialist
00026
NC
174400000X
Specialist
0005
NC
Other
Enumeration date
10/19/2010
Last updated
01/05/2011
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