Individual
SAMANTHA NIKOLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3995 MARCOLA RD, SPRINGFIELD, OR 97477-7948
(541) 726-1465
Mailing address
3995 MARCOLA RD, SPRINGFIELD, OR 97477-7948
(541) 726-1465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
Primary
C11028
OR
Other
Enumeration date
05/03/2021
Last updated
02/20/2026
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