Individual
SHAWANDA A DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 7TH AVE, LONG BRANCH, NJ 07740-6935
(732) 889-6065
Mailing address
103 7TH AVE, LONG BRANCH, NJ 07740-6935
(732) 889-6065
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00906300
NJ
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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