Individual
DR. TIMOTHY LELAND DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
600 N JORDAN AVE, BLOOMINGTON, IN 47405-3190
(812) 855-5711
Mailing address
600 N JORDAN AVE, BLOOMINGTON, IN 47405-3190
(812) 855-5711
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
20042069A
IN
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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