Provider Demographics
NPI:1598827230
Name:DAVIS, MARIA LYNN (MED)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:LYNN
Other - Last Name:KEMPF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:449 GERALD AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2402
Mailing Address - Country:US
Mailing Address - Phone:541-689-2071
Mailing Address - Fax:
Practice Address - Street 1:3995 MARCOLA RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-7948
Practice Address - Country:US
Practice Address - Phone:541-726-1465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist