Individual
AMY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5010 N STONE MILL RD STE B, BLOOMINGTON, IN 47408-9320
(812) 929-2193
Mailing address
3347 S OAKLAWN CIR, BLOOMINGTON, IN 47401-8546
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002506A
IN
Other
Enumeration date
03/19/2016
Last updated
03/19/2016
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