Individual
HENRY JEFFREY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9615 E 148TH ST, SUITE 1, NOBLESVILLE, IN 46060-4360
(317) 587-0533
(317) 674-0060
Mailing address
2506 WILLOWBROOK PKWY, SUITE 300, INDIANAPOLIS, IN 46205-1564
(317) 574-1254
(317) 674-0060
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20010296A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100128540
—
IN
Enumeration date
08/12/2005
Last updated
10/27/2015
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