Provider Demographics
NPI:1831346915
Name:DAVIS, AMY LEAH (MED)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LEAH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:76-778 HUALALAI RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-9776
Mailing Address - Country:US
Mailing Address - Phone:808-329-5202
Mailing Address - Fax:808-327-2729
Practice Address - Street 1:75-166 KALANI ST
Practice Address - Street 2:SUITE 202
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1857
Practice Address - Country:US
Practice Address - Phone:808-327-2724
Practice Address - Fax:808-327-2729
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker