Provider Demographics
NPI:1942285069
Name:DAVIS, ZOE ANN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ZOE
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 S CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-2124
Mailing Address - Country:US
Mailing Address - Phone:517-881-6843
Mailing Address - Fax:
Practice Address - Street 1:121 S COCHRAN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1568
Practice Address - Country:US
Practice Address - Phone:517-881-6843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-12
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010084161041C0700X, 104100000X
MI4101005120106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008987680OtherBLUE CROSS
MI8008987680OtherBLUE CROSS