Organization
STACEY DAVIS, PH.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY DAVIS PH.D. (LICENSED PSYCHOLOGIST/OWNER)
(352) 870-8173
Entity
Organization
Contact information
Practice address
11 NW 33RD CT, GAINESVILLE, FL 32607-2552
(352) 870-8173
Mailing address
11 NW 33RD CT, GAINESVILLE, FL 32607-2552
(352) 870-8173
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 7649
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY 7649
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
04/10/2015
Last updated
04/10/2015
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