Shane Davis
Counselor, Professional in Fredericksburg, VA. Individual provider (NPI-1).
NPI number1164071379
StatusActive
Last updated in NPPESOct 3, 2019
Details
- NPI
- 1164071379
- Entity type
- Individual (NPI-1)
- Name
- Shane Davis
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 10, 2019
- Last updated
- Oct 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 0701008416 | VA | Yes |
Practice location
4532 Plank RdFredericksburg, VA 22407-0139
Phone 804-230-0999
Mailing address
4532 Plank RdFredericksburg, VA 22407-0139
Phone 301-789-9458
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