Individual
DR. JULIA ---- DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., L.P.
Contact information
Practice address
430 OAK GROVE ST, SUITE 403, MINNEAPOLIS, MN 55403-3253
(612) 871-8684
(612) 871-2374
Mailing address
430 OAK GROVE ST, SUITE 403, MINNEAPOLIS, MN 55403-3253
(612) 871-8684
(612) 871-2374
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LP1216
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1329511
STATE IDENTIFICATION #
MN
Enumeration date
08/15/2006
Last updated
07/09/2007
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