Individual
SHAKA-CON DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1909 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4561
(980) 224-8078
Mailing address
1909 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4561
(980) 224-8078
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
1111111111111
NC
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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