Individual
CAITLYN ELIZABETH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
174 LMAH CENTER RD, LOGAN, WV 25601-4058
(304) 792-7130
(304) 896-5184
Mailing address
PO BOX 176, LOGAN, WV 25601-0176
(304) 792-7130
(304) 896-5184
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
25-973SUD
WV
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25-973SUD
WEST VIRGINIA CERTIFICATION BOARD FOR ADDICTION AND PREVENTION PROFESSIONALS, IN
WV
Enumeration date
10/13/2022
Last updated
08/14/2025
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