Individual
MYANGEL A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
162 SUNNY SLOPE DR, BRIDGETON, NJ 08302-5732
(856) 455-5441
Mailing address
PO BOX 867, BRIDGETON, NJ 08302-0457
(856) 455-5441
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00379600
NJ
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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