Individual provider · Type 1 NPI
Lydell Stacey Davis
Mental Health Counselor · Philadelphia, PA
NPI number
1083487409
Active
Practice location
1629 W Ruscomb St
Philadelphia, PA 19141-1539
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1083487409
Lydell Stacey Davis's National Provider Identifier is 1083487409, issued on Nov 7, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Philadelphia, PA. The record was last updated on Nov 7, 2023.