Individual
DEBORAH RUTH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
104 CENTER AVE STE 204, KODIAK, AK 99615-6393
(785) 224-5538
Mailing address
104 CENTER AVE STE 204, KODIAK, AK 99615-6393
(785) 224-5538
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
768
AK
101YM0800X
Mental Health Counselor
LPC 2212
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200656410A
—
KS
Enumeration date
07/14/2010
Last updated
08/13/2013
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