Individual
MARTHA MARIE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5959 GATEWAY BLVD W, SUITE 100, EL PASO, TX 79925-3331
(915) 799-9552
Mailing address
5959 GATEWAY BLVD W, SUITE 329, EL PASO, TX 79925-3331
(915) 799-9552
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421504
—
SC
Enumeration date
11/02/2007
Last updated
08/09/2016
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