Individual
MR. RICHARD DAVIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC II, NCAC I
Contact information
Practice address
3485 PROMENADE PL, APT 101, WALDORF, MD 20603-7280
(301) 848-6074
Mailing address
3485 PROMENADE PL, APT 101, WALDORF, MD 20603-7280
(301) 848-6074
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CACII1201
DC
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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