Davis, Mark Henderson

Davis, Mark Henderson is an individual health care provider with primary practice located at 5384 Street Ne Community Options Fridley, Fridley MN 55421. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Davis, Mark Henderson can be contacted via phone (763) 572-0004.

Contact Information

Primary practice address
5384 Street Ne Community Options Fridley Fridley MN 55421
Phone: (763) 572-0004
Fax: (763) 572-1295
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3796 Minnesota

Profile Details

NPI number 1457786998
LBN Legal business name Davis, Mark Henderson
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2013
Last updated Sep 3rd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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