Organization
CHARME S. DAVIDSON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARME S. S. DAVIDSON PH.D. (SOLE OWNER/SOLE MEMBER)
(612) 870-0510
Entity
Organization
Contact information
Practice address
211 N 1ST ST STE 285, MINNEAPOLIS, MN 55401-1480
(612) 870-0510
Mailing address
211 N 1ST ST STE 285, MINNEAPOLIS, MN 55401-1480
(612) 870-0510
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2642
MN
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285687889
INDIVIDUAL NPI
MN
05
—
627547800
—
MN
Enumeration date
10/24/2006
Last updated
07/07/2021
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