Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 279 | AL |
NPI | 1003030362 |
---|---|
Provider Name | Mrs. Michelle Wood Davidson |
First Address | Center Point, AL 35215-3406 |
Second Address | Center Point, AL 35215-3406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 18/10/2010 |