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Individual
MYLES DAVIS
Active
Individual
MYLES DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
1041C0700X
Clinical Social Worker
Primary
9438804-3501
UT
Other
Enumeration date
01/17/2012
Last updated
10/11/2019
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