Provider Demographics
NPI:1871631952
Name:DAVIS, CATHERINE W (LPA)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:W
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 CULBRETH DR
Mailing Address - Street 2:STE.211
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-3684
Mailing Address - Country:US
Mailing Address - Phone:910-799-6256
Mailing Address - Fax:910-256-0630
Practice Address - Street 1:1213 CULBRETH DR
Practice Address - Street 2:STE.211
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3684
Practice Address - Country:US
Practice Address - Phone:910-799-6256
Practice Address - Fax:910-256-0630
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2250103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist