Individual
MATTHEW TYLER DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPA
Contact information
Practice address
95 S LAUREL RD STE 1, LONDON, KY 40744-8300
(606) 770-5086
Mailing address
95 S LAUREL RD STE 1, LONDON, KY 40744-8300
(606) 770-5086
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
271738
KY
103T00000X
Psychologist
Primary
281597
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100773860
—
KY
Enumeration date
09/08/2021
Last updated
05/22/2025
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