Individual
MICHAEL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
86 BEACH ST, WESTERLY, RI 02891-2718
(401) 596-0969
Mailing address
18 BEECHWOOD BLVD, PLAINFIELD, CT 06374-2101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00731
RI
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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