Provider Demographics
NPI:1386267508
Name:DAVIS, DEVYN H (MA, NCC)
Entity type:Individual
Prefix:
First Name:DEVYN
Middle Name:H
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E BROWN RD UNIT 1054
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-3527
Mailing Address - Country:US
Mailing Address - Phone:602-316-0898
Mailing Address - Fax:
Practice Address - Street 1:30 E BROWN RD UNIT 1054
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-3527
Practice Address - Country:US
Practice Address - Phone:602-316-0898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-19000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health