Provider Demographics
NPI:1770899007
Name:DAVIES, KARRYLE LEI BECLES-DULAY (MA)
Entity type:Individual
Prefix:
First Name:KARRYLE LEI
Middle Name:BECLES-DULAY
Last Name:DAVIES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KARRYLE
Other - Middle Name:
Other - Last Name:DU LAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 E PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3265
Mailing Address - Country:US
Mailing Address - Phone:253-445-8120
Mailing Address - Fax:253-697-3730
Practice Address - Street 1:875 W MORENO AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906
Practice Address - Country:US
Practice Address - Phone:719-572-6200
Practice Address - Fax:719-572-6299
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CONLC13682171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health