Provider Demographics
NPI:1275540965
Name:DAVIES, PATRICIA SACCA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:SACCA
Last Name:DAVIES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:SACCA
Other - Last Name:DOMBROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 SUFFIELD ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:AGAWAN
Mailing Address - State:MA
Mailing Address - Zip Code:01001-1753
Mailing Address - Country:US
Mailing Address - Phone:413-786-3701
Mailing Address - Fax:413-786-3758
Practice Address - Street 1:46 SUFFIELD ST
Practice Address - Street 2:SUITE 4
Practice Address - City:AGAWAN
Practice Address - State:MA
Practice Address - Zip Code:01001-1753
Practice Address - Country:US
Practice Address - Phone:413-786-3701
Practice Address - Fax:413-786-3758
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2246103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
011498OtherVALUE OPTION/CHAMPUS
MA0511587Medicaid
S31435Medicare UPIN
W02574Medicare ID - Type Unspecified