Provider Demographics
NPI:1184488520
Name:DAVIS, ANGELIA GAIL (LPC)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:GAIL
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 1:6008 TIMBERLY RD N
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-2624
Mailing Address - Country:US
Mailing Address - Phone:251-610-0945
Mailing Address - Fax:
Practice Address - Street 1:6008 TIMBERLY RD N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2624
Practice Address - Country:US
Practice Address - Phone:251-610-0945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC05152101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health