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Individual

COURTNEY DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, CSAC, CSIT

Contact information

Practice address
721 AMERICAN AVE, SUITE 501, WAUKESHA, WI 53188-5071
(262) 928-2396
Mailing address
721 AMERICAN AVE, SUITE 501, WAUKESHA, WI 53188-5071
(262) 928-2396

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15453-130
WI
104100000X
Social Worker
Primary
127349-121
WI

Other

Enumeration date
05/01/2008
Last updated
10/16/2012
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