Provider Demographics
NPI:1649551482
Name:DAVIS, DEBRA ANN (PH D)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4608 E BERNEIL DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-5519
Mailing Address - Country:US
Mailing Address - Phone:602-625-4273
Mailing Address - Fax:
Practice Address - Street 1:7600 N 16TH ST
Practice Address - Street 2:SUITE 218
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4431
Practice Address - Country:US
Practice Address - Phone:602-625-4273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist