Organization
IRMA D DAVIS LMFT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRMA D DAVIS LMFT (OWNER)
(812) 249-3620
Entity
Organization
Contact information
Practice address
1400 SOUTH PUGH DRIVE, SUITE #3, TERRE HAUTE, IN 47802
(812) 249-3620
Mailing address
1400 SOUTH PUGH DRIVE, SUITE #3, TERRE HAUTE, IN 47802
(812) 249-3620
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35001703A
PROFESSIONAL LICENSING
IN
Enumeration date
04/18/2019
Last updated
04/18/2019
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