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Individual
REBECCA L DAVIS
Active
Individual
REBECCA L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT, SAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16081-131
WI
101YP2500X
Professional Counselor
Primary
2654-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033570882
—
WI
Enumeration date
03/08/2016
Last updated
11/07/2016
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