Provider Demographics
NPI:1376725044
Name:DAVIS, JAMIE J (MA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 MAIN ST STE 310
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2741
Mailing Address - Country:US
Mailing Address - Phone:304-232-7232
Mailing Address - Fax:304-232-1852
Practice Address - Street 1:1025 MAIN ST STE 310
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-2741
Practice Address - Country:US
Practice Address - Phone:304-232-7232
Practice Address - Fax:304-232-1852
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health