Individual
SHANE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1492 LIBERTY PKWY NW, ATLANTA, GA 30318-9381
(404) 444-9849
Mailing address
1492 LIBERTY PKWY NW, ATLANTA, GA 30318-9381
(404) 444-9849
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003134
GA
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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