Individual
ATHENA DAVOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
75 FORSYTH STREET, NORTHEASTERN UNIVERISTY SUITE 165G, BOSTON, MA 02115
(617) 373-8475
Mailing address
94 GRAYFIELD AVE, BOSTON, MA 02132-2507
(617) 417-3885
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2267837
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2267837
MA
Other
Enumeration date
08/11/2015
Last updated
10/11/2016
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