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Individual

BROOKE LAUREN DAVIDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1912 SOUTH ST APT C, PHILADELPHIA, PA 19146-1478
(914) 261-4122
Mailing address
1912 SOUTH ST APT C, PHILADELPHIA, PA 19146-1478
(914) 261-4122

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
SW133070
PA
1041C0700X
Clinical Social Worker
Primary
CW020264
PA

Other

Enumeration date
01/06/2016
Last updated
06/16/2020
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