Provider Demographics
NPI:1265855563
Name:DAVIS, ANNEKA
Entity Type:Individual
Prefix:
First Name:ANNEKA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9211 FLATLANDS AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3721
Mailing Address - Country:US
Mailing Address - Phone:347-960-2114
Mailing Address - Fax:
Practice Address - Street 1:9211 FLATLANDS AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3721
Practice Address - Country:US
Practice Address - Phone:347-960-2114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker