Provider Demographics
NPI:1568735983
Name:DAVIS, EUNICE LORINE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:EUNICE
Middle Name:LORINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 SW 220TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-3016
Mailing Address - Country:US
Mailing Address - Phone:305-256-6275
Mailing Address - Fax:305-256-6278
Practice Address - Street 1:11000 SW 220TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-3016
Practice Address - Country:US
Practice Address - Phone:305-256-6275
Practice Address - Fax:305-256-6278
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11126101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health