Provider Demographics
NPI:1861902603
Name:DAVIS, DONALD H (MBA, MS, CDMS, MFT,)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:H
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MBA, MS, CDMS, MFT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8430 W LAKE MEAD BLVD STE 139
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7672
Mailing Address - Country:US
Mailing Address - Phone:702-576-9882
Mailing Address - Fax:510-722-9739
Practice Address - Street 1:8430 W LAKE MEAD BLVD STE 139
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7672
Practice Address - Country:US
Practice Address - Phone:702-576-9882
Practice Address - Fax:510-722-9739
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health