Individual
MR. BRENT DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
92 PROSPECT ST, GLOUCESTER, MA 01930
(617) 605-2279
(978) 281-1739
Mailing address
92 PROSPECT ST, GLOUCESTER, MA 01930-3710
(617) 605-2279
(978) 281-1739
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
101369
MA
Other
Enumeration date
12/04/2006
Last updated
07/24/2018
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