Provider Demographics
NPI:1861654154
Name:DAVIS, ROBIN MARIE (BA)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5830 GOLDEN EAGLE DR
Mailing Address - Street 2:PO BOX 428
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248
Mailing Address - Country:US
Mailing Address - Phone:360-383-9258
Mailing Address - Fax:360-383-9242
Practice Address - Street 1:2806 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6930
Practice Address - Country:US
Practice Address - Phone:360-383-9258
Practice Address - Fax:360-383-9242
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00060476101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)