Individual
DEBRA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
222 SAINT JOHN ST STE 254, PORTLAND, ME 04102-3069
(207) 774-3650
Mailing address
15 HOMESTEAD AVE, SOUTH PORTLAND, ME 04106-3926
(207) 329-1052
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC7367
ME
Other
Enumeration date
07/17/2006
Last updated
04/24/2013
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