Individual
MARY W DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
665 W 4TH ST, WINSTON SALEM, NC 27101-2701
(336) 725-8389
(336) 714-3395
Mailing address
3340 WILITON WAY, HIGH POINT, NC 27260-5983
(336) 883-5551
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28443
NC
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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