Individual
BARRY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-E
Contact information
Practice address
4 AVIS DR STE 100, LATHAM, NY 12110-2650
(518) 560-4277
Mailing address
4 AVIS DR STE 100, LATHAM, NY 12110-2650
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R0713511
NY
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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