Individual
MARA DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
107 JOHN ST STE 3A, SOUTHPORT, CT 06890-1466
(203) 751-3775
Mailing address
107 JOHN ST STE 3A, SOUTHPORT, CT 06890-1466
(203) 751-3775
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
000541
CT
Other
Enumeration date
03/25/2016
Last updated
04/22/2020
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