| Wayne E. Davidson, Lmhc | |
|
14437 University Cove Pl Tampa FL 33613-3741 | |
| (813) 979-0535 | |
| (813) 975-9769 |
| Full Name | Wayne E. Davidson, Lmhc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14437 University Cove Pl, Tampa, Florida |
| Authorized Official Name and Position | Wayne Edward Davidson (PRESIDENT) |
| Authorized Official Contact | 8139790535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne E. Davidson, Lmhc 14437 University Cove Pl Tampa FL 33613-1546 Ph: (813) 979-0535 | Wayne E. Davidson, Lmhc 14437 University Cove Pl Tampa FL 33613-3741 Ph: (813) 979-0535 |
| NPI Number | 1154680346 |
|---|---|
| Provider Enumeration Date | 05/09/2012 |
| Last Update Date | 05/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154680346 | NPI | - | NPPES |
| 001296600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MH 4879 (Florida) | Primary |
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