Individual
CHARLES NELSON DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1730 E 3100 N STE 2, LAYTON, UT 84040-2408
(801) 643-1652
(801) 779-7808
Mailing address
1730 E 3100 N STE 2, LAYTON, UT 84040-2408
(801) 643-1652
(801) 779-7808
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
5891951-3904
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
04/16/2007
Last updated
07/07/2021
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