Provider Demographics
NPI:1467238352
Name:DAVIES, AUTUMN GAYLE
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:GAYLE
Last Name:DAVIES
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 1:1235 UNIVERSITY BLVD # 94
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1792
Mailing Address - Country:US
Mailing Address - Phone:226-347-1714
Mailing Address - Fax:
Practice Address - Street 1:1235 UNIVERSITY BLVD # 94
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1792
Practice Address - Country:US
Practice Address - Phone:226-347-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2305193-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health