Individual
COOPER EVIN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
616 GROVE ST N, ST PETERSBURG, FL 33701-2236
(262) 501-7590
Mailing address
616 GROVE ST N, ST PETERSBURG, FL 33701-2236
(262) 501-7590
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/22/2019
Last updated
09/22/2019
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