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Individual

INA-DALE NMN DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
12 GARDEN LN LOT 2, JACKSON, KY 41339-6569
(606) 568-5824
Mailing address
101 BULLDOG LN, HAZARD, KY 41701-6081
(606) 548-3696

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
KY

Other

Enumeration date
01/10/2025
Last updated
01/10/2025
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