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Individual

MR. KEVIN BRIAN DAVIDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A., L.P.A.

Contact information

Practice address
1309 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
(704) 933-3212
(704) 933-3221
Mailing address
117 IMPERIAL HEIGHTS RD, STATESVILLE, NC 28625-8969
(704) 876-3242

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2488
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6107125
NC
Enumeration date
07/11/2006
Last updated
11/28/2007
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