Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1194033845 |
---|---|
Provider Name | Dr. Angela Marie Davis |
First Address | Seattle, WA 98122-4410 |
Second Address | Seattle, WA 98122-4410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 17/12/2012 |