Individual
DIANE B DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
608 LANCASTER DR SE, SALEM, OR 97317-5643
(503) 877-1995
(888) 990-1352
Mailing address
608 LANCASTER DR SE, SALEM, OR 97317-5643
(503) 877-1995
(888) 990-1352
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R8713
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500829888
—
OR
Enumeration date
01/17/2024
Last updated
04/19/2024
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