Individual
VIVIAN M DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
1830 OWEN DR STE 202-4, FAYETTEVILLE, NC 28304-1611
(910) 568-6239
Mailing address
1022 BROOKHOLLOW DR APT 9, FAYETTEVILLE, NC 28314-1108
(910) 670-5965
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26730
NC
1041C0700X
Clinical Social Worker
P020651
NC
Other
Enumeration date
04/16/2020
Last updated
04/01/2025
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