Individual
DR. KELLY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6478
(540) 982-2463
Mailing address
2601 AVENHAM AVE SW, ROANOKE, VA 24014-1506
(720) 837-9659
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
BBH-LCPC-LIC-37760
MT
103TC0700X
Clinical Psychologist
Primary
0810008685
VA
Other
Enumeration date
08/24/2015
Last updated
10/09/2024
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