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Individual

JAMES RYAN DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
2202 EXECUTIVE DR, STE C, HAMPTON, VA 23666-6604
(757) 827-7707
Mailing address
2202 EXECUTIVE DR, STE C, HAMPTON, VA 23666-6604
(757) 827-7707

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6565
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
305099
ANTHEM
VA
01
5782627
AETNA
VA
01
O83259M
SENTARA HEALTH MANAGEMENT
Enumeration date
06/12/2007
Last updated
06/30/2008
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