Provider Demographics
NPI:1154949816
Name:DAVIS, RUKIYA (LMSW)
Entity type:Individual
Prefix:
First Name:RUKIYA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLA MARIA CATHOLIC CHARITIES 1111 BENFIELD BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108
Mailing Address - Country:US
Mailing Address - Phone:667-600-2494
Mailing Address - Fax:
Practice Address - Street 1:VILLA MARIA CATHOLIC CHARITIES 1111 BENFIELD BLVD
Practice Address - Street 2:STE 200
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108
Practice Address - Country:US
Practice Address - Phone:667-600-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker