Provider Demographics
NPI:1508273277
Name:DAVIS, MINNA GRABIN (LPC)
Entity Type:Individual
Prefix:
First Name:MINNA
Middle Name:GRABIN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 W GERMANTOWN PIKE APT 1807
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2203
Mailing Address - Country:US
Mailing Address - Phone:215-250-5311
Mailing Address - Fax:610-277-6425
Practice Address - Street 1:1100 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3820
Practice Address - Country:US
Practice Address - Phone:215-205-5311
Practice Address - Fax:610-277-6425
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional