Individual
BERNICE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 WASHINGTON ST, 401, EAST ORANGE, NJ 07017-1495
(973) 337-5029
Mailing address
75 LA FRANCE AVE, BLOOMFIELD, NJ 07003-7606
(973) 337-5029
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
35S100478500
NJ
Other
Enumeration date
08/20/2014
Last updated
08/21/2014
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