Provider Demographics
NPI:1467917419
Name:ALLISON NIEBES-DAVIS, PHD., LTD.
Entity Type:Organization
Organization Name:ALLISON NIEBES-DAVIS, PHD., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEBES-DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-441-4415
Mailing Address - Street 1:1327 BUTTERFIELD RD STE 604
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1008
Mailing Address - Country:US
Mailing Address - Phone:630-441-4415
Mailing Address - Fax:
Practice Address - Street 1:1327 BUTTERFIELD RD STE 604
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1008
Practice Address - Country:US
Practice Address - Phone:630-441-4415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty