Individual
LARRY D DAVIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13601 OFFICE PL STE 201, WOODBRIDGE, VA 22192-4213
(703) 492-8939
Mailing address
2463 CLOVER FIELD CIR, HERNDON, VA 20171-4313
(412) 326-5087
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0734005487
VA
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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