Individual
DR. STEPHEN P. DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2400 SE MIDPORT RD, SUITE 211, PORT ST LUCIE, FL 34952-4823
(772) 398-1003
(772) 398-1772
Mailing address
2400 SE MIDPORT RD, SUITE 211, PORT ST LUCIE, FL 34952-4823
(772) 398-1003
(772) 398-1772
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 5785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125175
VALUE OPTIONS
FL
01
—
5170247
AETNA
FL
01
—
54434
BC/BS
FL
01
—
82322
CIGNA
FL
01
—
IP029180
MAGELLAN PROVIDER NUMBER
FL
Enumeration date
07/17/2006
Last updated
07/08/2007
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