Provider Demographics
NPI:1811642721
Name:DAVIS, DONIA LYNN (CPC INTERN)
Entity type:Individual
Prefix:MRS
First Name:DONIA
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:
Credentials:CPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 S 6TH ST STE V
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6948
Mailing Address - Country:US
Mailing Address - Phone:310-848-8563
Mailing Address - Fax:
Practice Address - Street 1:8215 S EASTERN AVE STE 109
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2515
Practice Address - Country:US
Practice Address - Phone:702-252-8342
Practice Address - Fax:702-252-8349
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI5095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health